Dizziness Case Stumps Physicians, Leads Hospital To Elevate Psych Investment

Ryan Breshears, chief behavioral officer at Wellstar's Medical Group in Georgia, had a tough case to make: the hospital's behavioral costs were going up and its revenues were slightly down. "Not exactly the story the CFO needs to see," he quipped at the March 16th Integrated Primary Care & Behavioral Health Congress in Florida. Interestingly, rather than show months of statistics involving thousands of patients, Breshears used just two patient stories to show the CFO that investing in behavioral health made sense, that its value stretched far beyond revenue. In one case, a patient with repeated syncope (dizziness spells/fainting) was mismanaged by countless specialists and doctors over a one-year period. At various encounters, several believed that an $18,000 pacemaker was needed. Breshears eventually treated the patient and began to treat the syncope using therapy sessions and over time the dizziness subsided and the days between syncope events increased, all while the patient's quality of life (including social happiness) jumped. In a different case, a patient with migraines was a health system drain, getting injections, 5 ED visits, 4 hospitalizations for 11 days and a Mayo Clinic specialty consult, totaling around $25,000. But after 12 psych visits, the patient improved and didn't have any more hospitalizations and needed only two injections. The cost was $5,000, a $20,000 savings. In total, the two cases Breshears presented to his CFO helped tell the savings story: "Those 2 cases saved about $19,000, and paid for at least one third of the psych salaries."