Making Progress, Feb. ’23

When Russell Goin, our Chief People Officer, welcomed attendees to February’s 2023 Town Hall more than 633 lines were activated. Team members gathered around computer screens and smart phones, Zooming in to hear news and updates from Jay Higham, CEO; Julie Koenig, COO; and Ben Nordstrom, MD, PhD, CMO.  February’s Town Hall agenda included a recap of 2022 and a compelling request from Jay to stay focused on the core in 2023, doing what we do best the best way that we can.  Here are some highlights from Jay: 

We understand that the last few years have been tough. Fentanyl is making it harder to keep people in treatment, inflation is putting a strain on personal finances as well as company finances and everyone is working harder. Even with these challenges we remain focused on our mission to (1) help get people into treatment, (2) retain those we already have in treatment, and (3) support and empower all BHG team members to come through these times with personal and professional success. We have a lot to be proud of:

  1. We are making an impact on peoples’ lives. Over the last five years we’ve administered the Brief Addiction Monitor screening over 145,000 times.  The results show that patients continue to improve every year they remain in treatment. 
  2. We also have very high levels of patient satisfaction with 97% of patients reporting improved quality of life and Net Promoter Score of 57.  NPS is a measure of how likely customers are to refer friends or family.  A score above 0 is good.  As score of over 20 is excellent.  We have very satisfied patients and that is a testament to every one of our teammates and the quality of what we do.
  3. We have been successful in getting more people access to treatment with over 69,000 individual patients receiving services in 2022.  We ended 2022 with 2 percent more patients enrolled in treatment than we had at the beginning of the year.  One reason we were able to do that is because we found more ways for people to take advantage of funding for their treatment.  By the end of the year 75% of our patients were supported by government funding sources or commercial insurance.  Four years ago 75% of patients had to fund their own treatment out of pocket.
  4. We invested in training and development for teammates and voluntary full-time turnover was reduced by approximately 10%.  Behavioral health is a high burnout segment of health care with chronically high turnover among frontline staff.  We are committed to continuing to support our teammates and help them to be successful in their careers.
  5. Following rapid growth in 2021, we only opened two new locations in 2022.  The goal was to slow down, focus on the fundamentals, fill open positions, and make sure we are positioned for the future.

While we have much to be proud of, it’s also important to acknowledge challenges that we must contend with:

  1. Despite high levels of satisfaction, patient retention continued the decline we’ve seen since 2019.  As the BAM score shows, patients who stay in treatment have better outcomes.  High turnover is not good for patients and it puts a physical and emotional toll on everyone trying to take care of them.  The leading reason why patients leave treatment is that they don’t get comfortable on their medication.  In fact, 80% of patients discharge from treatment prior to achieving a minimally therapeutic dose.  The other two reasons people leave treatment are logistical (can’t get into the clinic or it is not convenient) and financial (can’t afford it).  Dr. Nordstrom will be working with everyone to help standardize an approach to getting patients safely to a therapeutic dose as quickly as possible.  And we ask everyone to think about how to make treatment more convenient (offering OBOT where appropriate, help patients to phase up quickly, expand hours of operation, to name a few ideas) and help patients to take advantage of their insurance and grant payment options.     
  2. As we shifted to more Medicaid, Medicare and commercial funding sources, we have many more administrative hoops to jump through from collecting deductibles, to getting prior authorizations and ensuring the clinical documentation supports payment.  This shift in payment source is undeniably good for patients.  But it also puts a strain on us to comply with these details, something we didn’t always achieve resulting in more denied claims and bad debt than is ideal.  This is why understanding how insurance works, how to collect deductibles and be up to date and thorough on clinical documentation affects us all. 
  3. Inflation hit all of us in 2022.  For the company our costs escalated dramatically during the year.  Normally I don’t like talking about company finances.  It is senior management’s responsibility to manage the finances and provide the resources for our teammates to provide life-saving treatment.  And I feel like you have all held up your end of the bargain.  But because costs have grown faster than revenue we had to have a reduction in team member head count during the year and a slowdown on any non-essential investments.  Unfortunately we also have to pause any normal merit increases at this time.  This is the last thing we want to do and understand the impact that inflation is having on everyone’s personal lives.  We will monitor the situation closely in the coming months and hope to be able to bring better news to you in the second half of the year regarding merit increases.  The priorities we are asking everyone to focus on is in support of achieving the growth we need to get back to investing in all aspects of the business.

For 2023 we will continue to focus on the fundamentals that will put us in position to be successful longer term.  These objectives are aligned with our mission to be a full-service provider of outpatient addiction treatment and a place where team members can achieve personal and professional success.  The main focus will continue to be:

  1. Admission on demand for patients.  The data is clear, if we can admit a patient when they are motivated, they are more likely get into treatment.
  2. Become a leading OBOT provider as well as a leading OTP provider.  Not everyone with OUD wants methadone and not everyone can accommodate the more demanding treatment requirements of an OTP.  More people affected by OUD access OBOT services than OTP services.  We should offer that alternative and become a full-service provider.  That will benefit patients and help us to grow the business.
  3. Improve patient retention.  Clinical data shows that BHG practice patterns vary a great deal across our treatment centers.  The average time to achieve a minimum therapeutic dose varies from a low of 18 days to a high of 109 days in different locations.   While this variation is lower than in years past, it is still too high.
  4. Make treatment as convenient and as accessible as possible. 
  5. Focus on collections to minimize bad debt.  We all work hard and should be paid for that hard work.  Nothing is more frustrating than providing the service but then not being paid and not being able to invest in the good work we do.   

There is no lack of opportunity.  The market continues to expand with the ongoing opioid epidemic now overshadowed by fentanyl and other novel street drugs of even more devastating power.  Our ability to deliver the full spectrum of addiction treatment and recovery is a key differentiator in our markets and improves our long-term viability as a new class of recovery center.  If we focus on these fundamentals and as we continue to evolve the operations, we will get back to investing in the business and everyone who is dedicated to helping the patients we serve. 

Post-Survey Insights from Russell Goin

We’ve had a strong early response to the Town Hall survey, and we are so appreciative of the feedback.  Once the survey is complete, we’ll share the comments, questions, and answers with you. We heard from many about ‘talk less, listen more’.  In the future, we want to do a better job answering your questions during the session.  Based on your input, we are already improving the format of the next Town Hall: we’ll provide prepared content for 30 minutes and leave 30 minutes to answer questions and hear comments.  And,  if we need to go overtime to answer all your questions, we will ensure the Zoom meeting invite allows us to do so.

Action items for you:

  1. For those who attended the call, please take five minutes to provide us with feedback by clicking on the following link and completing a brief survey: Town Hall Survey 
  2. If you missed the town hall, feel free to listen by clicking on the following link. The audio begins at the 6:45 time marker. Town Hall Recording
  3. To view the slide deck presented in the town hall, please click the following link. Town Hall Slide Deck
  4. Look for information in the upcoming months related to our 2023 Second Quarter Town Hall. 
Nancy Buttyan
Nancy Buttyan

Chief Marketing Officer