Inside the Launch and Ambition of Sheppard Pratt’s New Services Division

In the behavioral health world, Sheppard Pratt has long been a stalwart.

Founded in 1853, Towson, Maryland-based Sheppard Pratt is the nation’s largest nonprofit provider of mental health, substance use disorder (SUD), developmental disability, special education and social services. Ranked as one of the top hospitals for psychiatry by US News & World Report, Sheppard Pratt is now using its workforce to increase its reach outside of its suburban Baltimore homebase.

The result is Sheppard Pratt Solutions, a new division of the hospital that aims to leverage its mental health workforce to provide consulting, management services and development-based partnerships with various health systems across the country. Leading that effort is Stephen Merz, who was previously the CEO of Maine Behavioral Healthcare in Portland, Maine and who this year was named chief operating officer of Sheppard Pratt to lead the new division.

Merz says that Sheppard Pratt Solutions will formalize consulting services that the hospital already provides nationwide to health systems. Behavioral Health Business recently caught up with Merz at the 2021 Annual Meeting of the National Association for Behavioral Healthcare (NABH) in Washington, D.C., where he talked about what he has in mind with Sheppard Pratt Solutions.

In addition to expanding Sheppard Pratt’s nationwide reach, Merz said other goals for the new division include widening access to telehealth and value-based care, as well as providing additional resources to patients in its Maryland backyard. Portions of this interview have been edited for length and clarity.

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BHB: Let’s talk about Sheppard Pratt Solutions and why you think it is important to launch this division.

Merz: Sheppard Pratt is among the most unique behavioral health care organizations in the country. It has combined knowledge and experiences and brought services to scale in a region that serves behavioral health needs among all ages of people, from all different backgrounds and with all the different populations and payer mix. That is something that communities throughout America are very interested in having.

There are very few options currently in the market among different communities where they’re struggling with these challenges. We have a unique set of services, and many folks don’t even know about it. Sheppard Pratt Solutions was started to harness all of that intellectual capital and knowledge and share those services to others, so that they have the opportunity to recreate some of those services in their community. Our philosophy is that people should not go without access to behavioral healthcare.

What resources might have Sheppard Pratt had nationwide for providers before Sheppard Pratt Solutions? How might this new division complement the existence of such services?

There are relationships that Sheppard Pratt has around the country. Those relationships are largely through training a large workforce of behavioral health care leaders and providers, so that there are basically Shepherd Pratt people everywhere.

People will call us because they trained there, and they know how to run a system. They know what it should look like because they practiced there, and they want to create that in another community. So that’s one way just with those so many professionals. Earlier, I spoke to a colleague who said she attributed much of her career to those early formative days and Sheppard Pratt. That’s not an uncommon story.

The other thing is that most there’s so many leaders at Sheppard Pratt who hold positions of national leadership in either policy or clinical practice leadership, and so many of our leaders serve on councils. Our medical leaders have done research work across the country, so we have been very active for literally decades in that area.

With Sheppard Pratt Solutions on an informal basis, most of our services to date have been in regional contracts and regional work. And we have done consultations more to scale at a national level. With Sheppard Pratt Solutions, we are now formalizing it. 

When it comes to access, are there any particular gaps with nationwide delivery of behavioral health care that you think Sheppard Pratt Solutions can address?

Specifically, we’ve heard stories about how many organizations are struggling in that behavioral crisis spectrum, with their emergency departments being overwhelmed and health systems not being able to provide an ideal setting for patients. Sheppard Pratt has been very successful for decades operating crisis diversion, crisis stabilization and crisis respite levels of care. 

With areas like inpatient hospital level care, we hear from a lot of places that they have it or that they need it, but they don’t know how to run it. Child and adolescent services are another area that people have identified. It’s a specialty area, and there’s very few child and adolescent psychiatrists either out there or are practicing.

A lot of folks don’t know how to run that system, so the kids unfortunately get stuck at different layers. Sheppard Pratt is a well-evolved system, particularly for patients with developmental and autism spectrum disorders and patients that are otherwise misunderstood.

There’s a lot of telehealth options and the field is evolving rapidly. Many places don’t know in the sea of opportunities out there which service they’re going to work with, or how to know if they’re operating that effectively. We can help them with that.

Collaborative care is also a real opportunity, and that involves Sheppard Pratt services being embedded in primary care and other specialty settings in order to facilitate access to care for those who need it. We’ve found a lot of traction there.

Will there be satellites of this new division in other locations across the country, such as hospitals, universities or standalone centers?

We’ve only just formally announced our division. And in this short period of time, we’ve already been approached by several organizations that have very much expressed an interest in us. Prior to formalizing Sheppard Pratt Solutions, there had been an interest in satellite centers. 

We envision that we would have opportunities to partner with communities that have these needs, and with like-minded mission oriented organizations that would also want to do this in their community. If we find the right partnership, that’s something we’re interested in cultivating.

What is Sheppard Pratt’s view toward value-based care? Might the new division be a way to help more behavioral care providers become more aware of such care to be utilized in their services?

Most of the leaders at Sheppard Pratt have a rich background not only in behavioral health care services, but they come from generalized health care systems in medical/surgical organizations and full-service organizations. They absolutely make the connection and see the value of behavioral health interventions in managing the costs, quality, access and outcomes for medical services. Under a value-based care framework, Sheppard Pratt is very much focused on that. We have experience in running a value-based program model, and that’s absolutely a goal of Sheppard Pratt Solutions.

What are some near-term goals that Sheppard Pratt wishes to accomplish with this new division?

We have established some preliminary benchmarks, the first of which is to get our name out there. We have taken the position that we want to engage in partnerships with organizations that share our same philosophy and value to high quality care. That selection process will be one of mutual alignment and understanding with potential partners.

We’re not looking for a growth strategy that is going to see a Sheppard Pratt location at every street corner or every state in the country. It’s going to be an evolutionary process related to how we work with our partners.

We primarily are concentrating on serving on a consulting basis to organizations, and helping address some of their concerns. Where that goes to the next step, and where they may need more support, we’ll then pursue a deeper level of partnership. From where we are today, we can expect to see more visibility with Sheppard Pratt in the next three to five years than you see today from a physical perspective.

How might this new division complement what Sheppard Pratt already has at its Baltimore-area location?

Sheppard Pratt operates services with the scale to serve the entire community. Those services require a lot of resources, and a lot of infrastructure to basically operate a national best practice Center of Excellence. The development of the services outside of the greater Baltimore region to a national sphere will only grow and improve the overall organization by having these things at scale.

Take, for instance, specialty programs like those for OCD, or autism spectrum disorders or substance use disorders. Having a national network for which individuals can receive specialized treatment will ensure for the people in the greater Baltimore region, and nationally, that those services will exist. Having a larger referral base will help us because we’ll continue to have the volume of cases coming in. And for the people locally, those services are going to remain local. We’re continuing to make important strategic investments locally as we’re leveraging resources nationally.