Every healthcare stakeholder needs to understand that mental Health is a public health priority.
In this episode of Bite the Orange, Kevin Dedner, CEO and Founder of Hurdle, talks about the evolving mental healthcare space and their work to ensure people of color access it. The pandemic and the murder of George Floyd were two inflection points in the race and mental health conversation in the United States. Hurdle approaches the mental health space with an evidence-based technique that helps therapists develop cultural humility and responsiveness to support people of color as they enter the system. Hurdle aims to make access to mental health services available everywhere with different payment options but sells mainly to payers and employers who already have insurance plans for their employees. Kevin explains how Hurdle helps patients connect with a therapist fit for them and how the company supports and trains therapists to keep improving their work.
Tune in to learn from Kevin how you cannot separate race and mental health!
FULL EPISODE
BTO_Kevin Dedner: Audio automatically transcribed by Sonix
BTO_Kevin Dedner: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Emmanuel Fombu:
Welcome to Bite the Orange. Through our conversations, we create a roadmap for the future of health with the most impactful leaders in the space. This is your host, Dr. Manny Fombu. Let's make the future of healthcare a reality together.
Emmanuel Fombu:
Good morning, good afternoon, good evening, and good night, ladies and gentlemen. Welcome to another episode of Bite the Orange. Today we have a great innovative leader that I met about three years ago and a great event in San Francisco, and I'm very happy to have him on the show. I'm very proud of his accomplishments since we last spoke. He's a great innovator and someone that I'm honored to have on the show today. Welcome to the show, Kevin Dedner, the CEO of Hurdle Health.
Kevin Dedner:
Thank you, and thank you for having me, and thank you for the reminder of where we first met. I remember that day as if it were yesterday, and it's always so amazing to me how things come full circle, so here we are today.
Emmanuel Fombu:
That's right. Something about your company as well, because I lived in Washington, D.C. for a long time, before moving up to New York, when I was there, I never knew about the ecosystem of tech in D.C. itself. I've since found out about all the innovation that takes place in Washington, D.C., but before we begin, or all the audience members who are listening that don't know who Kevin Dedner is, tell us about you. Who's Kevin?
Kevin Dedner:
I'm from Arkansas and though that I've spent my career working in public health, there was a time that I prided myself in working on the most pressing public health issues of the day. That meant I spent time in tobacco control, I spent time in childhood obesity, I spent time in HIV/AIDS. There was this inflection point in my career where I began to understand and see mental health as a public health priority, and that was more from this professional lens. What I did not know when I was forming that opinion is that I would experience depression in myself. After I experienced depression, I looked around and realized that depression was more common than I had imagined and that many of my friends had suffered from depression. And I felt very compelled to try to do something about it, which led to the founding of our company, Hurdle Health.
Emmanuel Fombu:
Which is quite interesting, being an African-American man, and most of African-American men, myself, in the community is very difficult when we talk about these things, it's actually identifying and saying, hey, I'm depressed and I feel this way, because people look at everyone and they feel, it's ... successful, so how could they have depression? So what gave you that strength and touched you to come out to actually talk about this?
Kevin Dedner:
It's interesting because people often applaud me for having courage or something along that lines, and there are parts of me that are a bit ashamed to admit, very honestly that, it was not as if I had a lot of courage. My depression was so humbling and shifting, like to my life, then I ultimately got to a place where I had lost all ego and I didn't care what people thought about me. I was just sharing my experience because it was that sad and I was that vulnerable. But I think it's also worth mentioning that the first version of our company was focused on serving black men and in fact we rebranded the company. But the first version of the company was Henry Health and the Henry Health came from, and sure, you're familiar with the John Henry-ism construct, I'm not saying you would encourage all of your listeners to look into the John Henryism construct, but in simplicity, what the John Henryism construct argues is that black men exude a higher level of effort in everyday activities, and ultimately that effort takes an impact on their health. And that was the thesis of our company, is that black men were struggling in their day-to-day lives, and these challenges led to challenges in their mental health, and so we started with that thesis that we needed to find a way to destigmatize mental health for black men. And what I would say is that was before the pandemic, that was before the murder of George Floyd. And those two events, I think, have really caused us to be at a new inflection point, not only in terms of how we talk about race and the racial reckoning that we've seen happen in the country, but then number two, in really how we talk about mental health. And for those of us who are in the medical field and public health field and mental health field, I think that we have to come to terms very quickly with what the legacy of the pandemic, the legacy of the murder of George Floyd will be on our mental health ... selectively. We're already starting to see this play out with increases in depression, increases in anxiety, increases in suicidal ideation, as well as suicide. And for people of color who were already 20% more likely to have mental health problems, 50% more likely to terminate therapy prematurely, these are really critical times that we tweak our mental healthcare system to make sure that it works for everyone, which is why what we're doing at Hurdle is so important and I think is the direction that the entire mental healthcare field must go.
Emmanuel Fombu:
Which is very interesting. I'm happy you brought it up, Kevin. So now we're talking about Hurdle Health, as you mentioned. So tell us how Hurdle works.
Kevin Dedner:
Yeah, so we are in our core a teletherapy business, but the thing that makes us different is that we train our therapists in an evidence-based technique that helps them develop more cultural humility and cultural responsiveness. At Hurdle, we face a hard and unfortunate truth, and that truth is that the mental healthcare system as we know it, was not designed for everyone, that we have a system that has literally been designed for middle-class white Americans who have experienced a single trauma. And certainly, I don't want to become too professorial here, but when we understand the history of our mental healthcare system, the biases and discrimination that is rooted in it, and we think about what we're seeing in terms of the increase in treatment-seeking behavior among people of color is a pressing priority that we make sure we adjust the system with all of its biases, built-in biases, to support people of color as they're entering into the system.
Emmanuel Fombu:
Which is very interesting. And even outside of mental health space, for example, look, I think about diets, right? If you try to have a new diet and sometimes I look at my diet plants and they go quinoa, like, you know, I'm African, quinoa is not part of my diet. It's hard to understand how that fits into my meals because it's not personalized to me and my diet and preferences. And so when you go about getting therapists that work in your program, is there some kind of questionaire, is there intake, is this a screening process of the ideal kind of therapists that you're looking for?
Kevin Dedner:
Yeah, that's a great question. First of all, we, all of our therapists are master-level therapists and we look for therapists with experience in CBT as well as trauma-informed care. But the most important thing is we layer it with our training, which was built by one of our clinical advisors, Dr. Norma Day-Vines, is a professor at Johns Hopkins, and the training is all about cultural humility and cultural responsiveness. In fact, the training has been certified by the National Board of Counselors. And so when our therapists come on board, we train them in this training, they get a CEU credit for undergoing the training, but more importantly, we offer continuous support to our therapists. We have monthly clinical rounds, our therapists can request clinical consultations, and we are, we're just starting to collect clinical outcome data, but the data is very promising. The one small factor that I'll share with you is our clients are persisting four times the historical national averages of how long people stay in care, and that is remarkable for people of color because it means that they're more likely to complete their care plans to see positive outcomes. And so we're incredibly excited about what that means, not only for Hurdle, but also for the mental health field overall, because that means techniques like ours are leading the way in reimagining what mental healthcare should look like, and more importantly, I know you appreciate, how therapists are trained. And finally, let me just say one thing, because this is true not only in the mental health field, but it is also true in the public health as well as medical field. We have accepted some language that I think now we need to start to push back against. We have told people that they can become culturally competent and you just drew out the distinctions about your culture, the food that you want to eat, and like just the notion that even I could proclaim that I'm competent in your culture, like just let's just take a step back and think about that. Like, why don't we embrace that for the last 20 years or so? Like, we literally tell people that they could take a two-hour, three-hour workshop and walk away and claim cultural competency. So that's why we believe at Hurdle, this idea of culture humility, culture responsiveness is the better way to go.
Emmanuel Fombu:
Which is very interesting because I really like your model and how you take, I mean, you have culture first, which goes down to the center of the patient first ..., you're a culture first kind of model where that individual, the care is centered on that individual in personalize it to them, so you have a very niche angle where you go in, and then not just that, but you have these evidence-based things where you have the Hurdle Cultural Responsiveness training program, which you actually talked about in addition to a cognitive behavioral therapy, like CBT, right? So you have that part of it. So this scientifically based, evidence-based, and of course, with time looking at outcomes, but you'll have some great numbers, I'm sure, in the future, in my next discussion, will be happy to share more of those discussions, but you connect this to build like a best practice. So who are you targeting? So it was an entry point, right? Because I was quite impressed by looking on the list, in a very short time Kevin, that this is ... or less ... of the number of partnership ... So up to Oscar, like facility names, they applied for Blue Cross Blue Shield, which takes a while to do this. I'm very proud of you for doing that. Tell us, what is the right entry point, or how do you sell your business?
Kevin Dedner:
Yeah, no, that is a great question and I appreciate the way you tee that up. We started out as a B2C business selling directly to consumers and we still believe that it's an important door to keep open, but we all know that in America, healthcare is, and the way that most people access healthcare is through their employer, and also that by default means through their payer. So we are selling directly to employers and payers. We work with an employer, sometimes we have a PEPM and we process claims, sometimes we're not processing claims and we have a higher PEPM. So there are a couple of ways that companies can work with us, there are ways that payers can work more directly with us, because, as you alluded to, we do work directly with payers. We have national agreements with Aetna, Cigna, United, we also have delegated credentialing. And what that means is there are employers who use these payers to manage their benefits, we can work directly with them and process plans, and obviously people want to add this ... as a benefit to their employees, that can be the same. Our goal is to make sure that our offering is available everywhere and there are lots of different ways that people are paying for access to healthcare and mental health services, and so we want to be available to work across all of those mediums.
Emmanuel Fombu:
... Which is fantastic. So let's say, I want to do like a traditional case study, so if I am a patient, someone that needs therapy, I go, I download the app, I could go to the App Store and download Hurdle, right? And I go in, I sign up. What does that person ...? I like the matching process, I want you to talk about that, how you match the individual to the therapist? Then I join, and then what happens when you ...?
Kevin Dedner:
A company ... that you just played out, so maybe let's just play with two of those as a possibility. Okay, first of all, let's say that you are, you heard this podcast and you're like, that sounds interesting. I need mental healthcare services. I'm going to go to your website and register. You go to our website and you register and you just come in as an individual. And number one, you could pay out of pocket if you wanted to. But also it is highly likely that we will be in network with the payer who insures you, and so in that way you go through the registration process, we verify your insurance, we tell you what your co-pay is, and you can use your insurance as a form of payment. Now, we'll take the second part of your conversation about the matching and so forth in the second conversation. Let me give you another scenario, somebody is listening to this podcast and they're an employer and they decide that they want this available to their employees, and let's just say they use Aetna to manage their benefits. They come and they work directly with us to coordinate an implementation plan to their employees, we agree on probably a lower PEPM and we process claims, but we have a robust implementation plan and we announce the benefit to their employees, their employees have a special landing page, and they go and register. Now, so we give you two possibilities that people have registered. So what's happening after that? And this is, I'm so glad to keep this up because this is really important. In the industry right now, there's a lot of talk about matching and let me just set the stage about matching. Less than three or 4% of our therapists in their country are people of color. So the idea that we have the capacity to match is an unreasonable expectation, which is why at Hurdle, we argue that cultural humility and cultural responsiveness is a better approach than matching, like making sure that people can support people no matter how diverse they are when they show up is really where we meet this industry. I just was on Capitol Hill yesterday talking to members of Congress about our workforces, and my hypothesis, it will be 20 years before we resolve these workforce issues because we've got, these are long-term pipeline issues. There are a lot of systemic things tied to whether or not a young person decides to pursue psychology. It's not a very high-paying field, so if you have people who are trying to figure out how to build wealth and generational wealth, it's just it's a very hard career to set yourself up for. And to be honest with you, we're not talking to kids in junior high, we're not going to be setting them up to get in this pipeline. So I just want to be clear about this issue of matching, because I don't want to get derailed here and go down a rabbit hole, this issue of matching is not a feasible thing. So what we do at Hurdle is we use a language pair, we're not using that algorithm right now to pair people with a therapist. People complete a questionnaire, we're looking at it and pairing them with the therapist, with the experience unique to what they're experiencing in life. And so for us, that means we have a very robust member ... team that is literally holding people's pay-in to get them to set. And my goal and it's the companies, and what we've seen with our clients is if we can get people to that third session, we are very likely to ..., to, for them to complete their care plan. So we're trying to make sure we get people to session number three. There's something magical that's happening in session two, three where that therapeutic alliance is forming, right, that provides a fit clicks and they go to 10 to 12 sessions after that. After they've registered, they do get access to a mobile app. Our mobile app has daily motivational messages as well as meditations. Right now that's not available to the public, it's only available to enterprise customers. But at the top of the year, we do plan to make that available to the public and there will be a free version available for people who are literally even not in therapy, and then there are a lots more, but will be behind the pay.
Emmanuel Fombu:
Which is quite impressive. He lives in Washington, D.C. so ... going up to Capitol Hill and the politics of policy, something you probably gotten used to over time. I should think It's quite impressive getting all the space to buy in, because I think that's a particular need, right? In every company you have is diversity and inclusion discussions that take place, but when it comes to offers of therapy, which like teletherapy, and solutions like Hurdle Health, I've hardly filed this, and so it's enterprises that are there. So I would say anyone listening to this, if you're an employer, you work for a company, please let them know about Hurdle Health, right, and the benefits that it brings to the community. But with that being said, today, I went on your website and I was looking at carriers, I was hoping to apply for a job on there, and I see you are hiring for therapists and you have the Hurdle therapist network. Are those independent therapists or is it like work in a model, we have like contact in business, or are these therapists hired by Hurdle?
Kevin Dedner:
Yeah, that's a great question. We have a hybrid model, but we lean more toward on our therapists who are full-time employed with us. And ... we talk about our care model is really important that we can engage with therapists and support therapists as they're supporting diverse populations, and, if we take a step back and talk about who some of our clients look like, we're talking about people who have not traditionally accessed therapy, who have historical collective trauma that they're working to heal from. And much of this trauma that people of color are working to heal from and overcome really just became visible to most people after the murder of George Floyd. I actually was having a talk with ... earlier today, and I was just talking about how the historians are classifying this period as the racial reckoning, right? The racial reckoning means that some people have now come to understand what many of us have been talking about all the time, that police get behind us and our heartbeats increase, right? Or that when we go to the water cooler, we have to deal with microaggressions, and what we know science-wise, that multiple microaggressions over a period of time become the equivalent of a traumatic event, right? So we're now bringing people into therapy who are processing these experiences, and I think that in itself, a remarkable place for us to be in the mental healthcare system that we are, we're now helping people like heal from like these deep-seated wounds in our country. And if there are employers who are out there listening, who made DE&I commitments, what better way to honor your commitment to your employees than making sure that you have a benefit that speaks to all employees? Like that's the thing about our offering, is that it is a benefit that speaks to all employees because the idea of culture humility, the idea of cultural responsiveness is not an idea for black people.
Emmanuel Fombu:
I don't think there's a better way to explain that, but with that being said, I don't want us to wrap up without saying this has been like smooth sailing. I'm sure there has been some challenges. So what has been like the biggest bottleneck right along this journey that you've been on?
Kevin Dedner:
I think, I actually feel guilty saying this because I've been so fortunate. When you lead a venture back company, and always worried about I got to raise more money, and we know less than 2% of venture capital goes to minority founders, which is why I put that caveat out about it very early, saying I feel guilty acknowledging, just because I know that there are so many others who have brilliant ideas who probably are much, much more smarter than I am, right, whose ideas are dying on the grapevine because they can't get their ideas funded. But we struggle, I wish I didn't have to raise money. I wish I could just put my head down and work on the solution, but that's not how this works. I do have to pour energy into fundraising. What I will tell you, and I really just wanted to say this earlier, you talked about how payers have responded. I will tell you, I have been in public health conversations all of my career. The turn I saw in the payer community around health equity and health disparities, around, after the death of George Floyd, deserve to be written about and deserve to be celebrated. Like payers have really stepped up and said, what can we do differently? We now are willing to acknowledge, and you're a physician, you know this, We're now willing to acknowledge the elephant in the room. What can we do differently? And I just want to commend, we obviously work with a lot of payers, but I just think that they deserve a lot of credit for finally coming to terms with these issues around health equity and health disparities.
Emmanuel Fombu:
This is fascinating. I know, no better way to wrap up the show. Thanks a lot, Kevin, for having you on board. I would love to check in with you in the near future to see how things are going there. But if you listen, you're a payer, you're an investor and we have venture of these listeners as well, let's make Kevin's life easy. I think he's done a fantastic job, he is a fantastic human. I spend a lot of time with him to talk. I'll end up visiting soon in D.C., Kev. Thank you for coming on the show.
Kevin Dedner:
Thank you, it's been my pleasure.
Emmanuel Fombu:
All right, thank you.
Emmanuel Fombu:
Thank you for listening to Bite the Orange. If you want to change healthcare with us, please contact us at info@EmmanuelFombu.com or you can visit us at EmmanuelFombu.com or BiteTheOrange.com. If you liked this episode and want more information about us, you can also visit us at EmmanuelFombu.com.
Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.
Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.
Sonix has many features that you'd love including share transcripts, automatic transcription software, world-class support, upload many different filetypes, and easily transcribe your Zoom meetings. Try Sonix for free today.
About kevin dedner:
Kevin Dedner serves as founder and CEO of Washington-D.C.-based Hurdle, which provides culturally intentional teletherapy putting culture first so that everyone feels seen, heard, and understood.
Kevin is deeply connected to Hurdle’s mission, having suffered a period of depression where he found the biggest challenge to effective care was finding the right therapist who could truly understand and connect with his struggles as an African American man. His company equips mental health professionals with the skills needed to effectively address issues of race, ethnicity, class, and culture. Kevin is a best-selling author. The Joy of the Disinherited: Essays on Oppression, Trauma, and Black Mental Health is his first book. Through honest, captivating, and humane stories of his past and eye-opening research into the effects of racism on mental health, Kevin argues in his book that we must knock down the invisible barriers to mental healthcare.
Kevin is an award-winning public speaker with over 20 years of public health experience. He is often a featured speaker at health conferences. He currently serves as an Optum Clinical and Scientific Advisory Council member. In 2021, Kevin was named one of the top 50 in Digital Health by Rock Health. He was also recently named one of 75 Black healthcare leaders to know by Becker’s Hospital Review.
Kevin graduated from the University of Arkansas in Fayetteville and has a Master of Public Health from Benedictine University in Illinois.
Things You’ll Learn:
Mental health needs to be destigmatized for black men.
People of color are 20% more likely to have mental health problems and 50% more likely to end therapy prematurely.
The mental healthcare system was designed for middle-class white Americans who have experienced a single trauma, not the plethora of identities we find today.
Hurdle Health’s clients persist four times the national average and are more likely to complete their care plans.
In the United States, the way that most people access healthcare is through their employers.
Less than 4% of therapists in the United States are people of color.
There has been a noticeable positive turn in the payer community around health equity and health disparities after the death of George Floyd.