“If we think what we are doing today will serve us tomorrow, then we will not be here tomorrow.” This comment, made at The 2020 Strategy & Innovation Institute keynote address Innovation By Design: Capturing Value In Health Care by Carl Clark, M.D., chief executive officer of the Mental Health Center of Denver (MHCD), are words of wisdom for every executive team member of a specialty provider organization. Innovation is no longer a luxury, it is a strategic survival skill.
The pandemic has sped the need for innovation in service delivery. On one hand, it has changed “customer preference” (both consumers and health plans) for services—more virtual, more home-based, and more data-driven (see A Blueprint For Organizational Sustainability In A Disrupted Health & Human Service Market: Planning To Move From Crisis To Recovery and Aggressive Business Development Strategies – Adding To The Top Line With Breakthrough Services – An Overview). On the other hand, many organizations have been busy introducing new services designed for these changing times. There are four announcements that caught my attention, each an example of a game changer for specialty provider organization market positioning:
- Optum’s purchase of AbleTo (see UnitedHealth’s Optum Is In Advanced Talks To Acquire Remote Mental Health Provider Ableto For About $470 Million). An on-line behavioral health service delivery system now owned by a major health insuring organization, UnitedHealth Group.
- Heal’s launch of “Heal Pass” (see Heal Launches New ‘Health Assurance’ Offering). A program that offers physician house calls and next day shipping of medications for a monthly fee of $49 dollars.
- Mayo Clinic’s expansion of nationwide acute care services at home (see Mayo Clinic Teams With Medically Home To Launch National Hospital-At-Home Model). Through a partnership with Medically Home and a new “hospital-at-home” advanced care platform, Mayo Clinic’s physicians can deliver high-intensity services to and remotely monitor consumers at home.
- Quartet’s arrangement with health plans to support mental health and primary care integration through its virtual care platform and coordinated network of mental health professionals (see Blue Cross NC & Quartet Launch Mental Health Collaboration), and to use its technology platform to provide virtual tele-psychiatry and tele-therapy to members (see Centene & Quartet Health Expand Partnership Nationwide To Help Ensure Members Have Access To Critical Behavioral Health Care During COVID-19 Pandemic & Beyond).
Certainly, these new service offerings aren’t appropriate for all consumers—many consumers with chronic conditions and complex needs will need another approach. But many will prefer these new options—and will embrace the convenience and value they offer. And more importantly, it is these competitive forces that will reshape the service delivery system and force provider organization managers to change their service line portfolio to remain sustainable. Innovation is the solution to this strategic dilemma. As Dr. Clark says, “Innovation is about figuring out how to get people what they need in a new way, when you can’t do the things the way you usually would.”
But how do you nurture a mindset of innovation? How do you embed it in the way you do business? And how do you scale for success? Dr. Clark described five fundamentals that provider organization executives should think about—strategy, culture, resources, partnerships, and agility.
Innovation is strategic. Innovation must be baked into your strategic planning. Dr. Clark advises that you start by asking the key questions. What is the problem you want to solve? What value does it bring (to the organization, to the community, to the consumers you serve)? Does the innovative solution align with your strategic plan? What resources do you need and do you have the means to obtain them? What is the tolerance for risk within your organization?
At MHCD, innovation is driven by one key question—how to expand access to care. Only two in five people who need care for mental illness and addictions can access that care, says Dr. Clark. Therefore, they are solving so the three in five can also get care. They are thinking about how to expand the capacity of clinical professionals to see more people through technology supports that act as “force multipliers” (see Robots As A Staffing ‘Force Multiplier’).
“We look for conflict and complaints, which are opportunities to do something new and different,” explained Dr. Clark.
Innovation is a culture. A culture of innovation must start from the top but cascade down to every level of staff and those served. Executives at MHCD describe it as human-centered design engaging the people served to develop the solutions, cutting through the red tape to solve at the line level where possible, or escalating the issues quickly to the level where they can be solved. When the pandemic enforced remote work, managers at MHCD found a way to “skip the meetings and solve the problems” through daily huddles where quick decisions could be made.
Innovation also leverages input from consumers and the community. MHCD partnered with one of its local neighborhoods to create the Dahlia Campus for Health & Well-Being to support high risk youth in the community and bought four acres of land with the idea of establishing a 20,000 square foot clinic. But when they asked the community what it needed to thrive, more urgent problems became evident. There was a food desert and food swamps, with mostly junk food. MHCD could not solve for behavioral health issues without addressing the social determinants of health. So, they transformed the area into an urban farm with community gardens, a greenhouse, a teaching kitchen, a pre-school, and a pediatrics clinic. And when the kitchens had to close during the pandemic, they still found ways to get the food out. “Getting in with the community created something we never imagined,” said Dr. Clark.
Innovation needs resources. Initially, MHCD had a whole portfolio of ideas but did not dedicate the resources to nurturing them. “We had our core business and innovation was ‘other duties as assigned.’ It was like oil and water,” said Dr. Clark. It wasn’t until they created an Innovation Lab and dedicated funding and staff that they were able to make innovation happen (see Prioritizing Innovation: It’s About Discipline & Thinking Creatively To Solve Challenges). Today, MHCD invests 15% of its resources in innovation initiatives.
While not every provider organization might have the ability to scale innovation at the same level, a mindset of innovation will help executives get creative about funding. From talking to payers who are eager to support innovation (see Think Like A Health Plan and Technology As A Game Changer For I/DD Support Services) to “crowdfunding,” the options are many when the solutions are evident.
Innovation thrives on partnerships. The resources to support innovation can come from strategic partnerships. Public-private partnerships have proved beneficial for MHCD and the communities it serves.
In 2016, MHCD set out on an ambitious project to help address the housing crisis in Denver (approximately 400 chronically homeless individuals were costing the city $11 million each year). The city issued social impact bonds to raise funds to build a 60-unit apartment building to house the homeless. And MHCD applied the “Housing First” model principles and offered trauma-informed approach to help design the apartments with personal safety in mind. Today, previously homeless consumers are staying in the apartments and either working or attending school.
Another innovative program that thrives on a public-private partnership is MHCD’s “co-responder” program where licensed clinical social workers (LCSWs) accompany police on a first visit when there are issues involving consumers with behavioral health challenges. This intervention at the first responder level helps get people into care quickly. MHCD piloted the program with six LCSWs and was able to reduce the number of people going to jail from 97% to 7% of encounters.
“Innovation enables us to get people what they need right at the moment they need it,” said Dr. Clark and informed us that once the pilot proved successful, they added 24 LCSWs to scale up the program for impact.
Innovation demands agility. For organizations just getting started on innovation, Dr. Clark recommended a rapid-fire process, “Come up with the idea, prototype it, test it, and figure out what worked well and what didn’t.”
There are two ways of thinking when it comes to innovation. The first is exploitative; taking something you already do and improving it. The second is exploratory; starting from scratch and making broad jumps. Exploration, while it can have a big pay off in the end, is risky. So, start small and leverage the resources you already have. As Dr. Clark suggested, “The innovative solution doesn’t have to be completely thought out before you start. Being agile is key—you can modify based on feedback as you go.” He also advised focusing on “the how” rather than “the what” and developing evidence-based practices right from the get-go.
Executives who support innovation must accept that failure is often part of the process (see Incorporating Innovation Into Everyday Operations: A New Strategy For Sustainability). “In health care, we don’t want to make mistakes. But for an innovative culture to work, we have to challenge people to take risks and make it okay if things don’t work out. In any failure we ask, what did we learn from this and what didn’t we know before that we know now?” pointed out Dr. Clark.
The science to service gap of seventeen years (see After Telehealth, Then What) in health and human services is not going to stand with these competitive pressures. Innovation in every aspect of services and operations is essential to survival. For more on innovative solutions, check out these resources in The OPEN MINDS Industry Library:
- The Mental Health Center Of Denver’s Innovation Technology Lab Program: An OPEN MINDS Program Profile
- Open Forum On Design Thinking & Innovation
- Leveraging Virtual Capacity & Moving To Use Cases Beyond Therapy
- A Guide To Implementing Innovation
- Robots As A Staffing ‘Force Multiplier’
- Technology As A Game Changer For I/DD Support Services
- The Recovery Formula: Strategy + Innovation + Preparing For (Some) Failure
- Remaining A Niche Provider Organization Requires New Marketing Thinking
- Innovation Success In Three Steps
- Designing & Implementing Innovative Treatment Programs: An OPEN MINDS Executive Summit & Showcase
And for even more on making innovation happen, join us on August 25 for The OPEN MINDS Care Innovation Summit: Solving The Problem Of Access For Consumers With Complex Care Needs. Registration is free for Elite members of the OPEN MINDS Circle.