Alliance Health’s transformation to integrated care took a leap forward in October when we welcomed aboard new Chief Medical Officer Dr. Mehul Mankad, MD. Dr. Mankad brings a wealth of integrated care experience from 15 years of work as Chief of Psychiatry at the Durham VA Medical Center and Assistant Professor at the Duke University Department of Psychiatry.
Dr. Mankad said he hopes his experience working in integrated care can help Alliance get to the next step in our journey. “One of the many pieces I learned at the VA is that the lower the barriers and the fewer obstacles you present to communication between physical and mental health, the better for the patient.”
“The idea that mind and body are separate has been something that we’ve accepted for a few centuries, ever since the era of philosopher René Descartes, who famously separated mind from body in his writing,” Dr. Mankad said. “But it’s a false separation. The mind is part of the brain, and the brain is part of the body, and the body is all connected. So the idea that we should move toward whole health is long overdue, but there’s no time like the present. We have to move in that direction.”
Dr. Mankad said that the hoped-for benefit of delivering integrated care to the people we serve is that improving people’s mental health improves their physical health. “And we’ve certainly seen that at Alliance since the inception of the company,” he said. “But I think the piece that a lot of people are excited about, including myself, is that improving people’s physical health will improve their mental health as well. And then the third piece that I would add is what were called the social determinants of health, which we now call the social drivers of health. Being respectful of the social drivers of health can actually be more impactful on the physical and mental health of our members than anything else we can do.”
The transition to integrated care delivery through North Carolina’s upcoming Medicaid Tailored Plan need not be difficult, Dr. Mankad said, but it involves building relationships, and opening communication and freer exchange of information – within applicable rules and regulations, of course.
“I’m hopeful that some of the advanced information systems that Alliance has invested in over the past few years, namely the Jiva care management platform, will help facilitate this exchange and also bring in the social drivers of health,” he said. “Then I guess the next step is to use the powerful information that we have to educate providers on the mental health and physical health side as the patients that they care for are changing. If we can deliver information in a proactive way, then we can help the providers intervene early.”
“The way that I’m looking at the Tailored Plan transition is more as an opportunity than a reason to be afraid,” Dr. Mankad said. “It’s going to allow Alliance to focus on those people Alliance is best at helping. The members who are identified as being in the future Tailored Plan are precisely the ones we’re good at caring for. That is more exciting to me than anything else.”
Dr. Mankad cited Alliance’s intellectual power as one of the things that attracted him to the organization. “People here are doing so many great things simultaneously; they are very thoughtful about Medicaid Transformation and often serve as advisers to the state. Whether it’s in state government or even the legislature, people often turn to Alliance, not just because they are close by, but because they know that people at Alliance have been thinking about critical issues for the future of our most vulnerable people in North Carolina,” he said.
“The other thing is putting your money where your mouth is. Alliance really does deliver on its promise to be a leader in managed mental health in North Carolina. For example, the kinds of things being done with Alliance’s care management system are on the cutting edge, and I think that’s really impressive. So on the one hand, the folks at Alliance are leading the charge with our daily work, but the other thing that people are doing simultaneously at Alliance is thinking very intently about the future. The language that I’ve heard a lot of people use here is that they are building this airplane while it’s in flight, and it’s scary, but it’s necessary.”
Dr. Mankad’s experience at the VA also aligns well with Alliance’s position of having more veterans and military families in our service area than any other North Carolina MCO. “I’m very excited that one of Alliance’s areas is in Cumberland county,” he said.
One in nine North Carolinians is either a veteran or active duty military, and while the VA focuses on services to veterans themselves, the agency does not currently focus on direct service to dependents of veterans. “A lot of people don’t realize that not all veterans have health coverage for their family members, and so Alliance may have a very critical role to play for the halo of people that surround veterans. I’m happy to help the employees at Alliance, and to whatever extent the providers that work with Alliance, develop their veteran-friendly approach,” he said.