In the News: CEO CFO Magazine

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*Interview originally published on CEO CFO Magazine

CEOCFO: Mr. Appleton, you are a leader in the social prescribing movement in the US. Where did the idea for Art Pharmacy come from?

Appleton: Art Pharmacy emerged to address the need for health plans and large health systems to increase the availability of mental health services. Our approach brings together a strong arts & health research field that has demonstrated, for 40+ years, the effect of engaging with the arts to benefit patient health. Research out of Johns Hopkins, Harvard, University of Florida and beyond tells us the clinical benefit of arts engagement but there is a need for a delivery mechanism that enables treatment plan compliance and patient access. Art Pharmacy is the model for that – and much more.

CEOCFO: Is the idea of arts & culture interventions benefiting mental health relatively new, or has it been around for a while?

Appleton: I like to answer this question by reminding people that artists have been healers since the beginning of humankind. Decades ago, the arts and health field started to take form. Some of the ways that arts and culture engagement improves mental health are a result of the hormonal impact, others are related to secondary effects on our body.

CEOCFO: Would you tell us about the arts programs that you offer? Are they activity, visual or both?

Appleton: The types of arts and culture activities that we connect our patients to range across artistic disciplines, visual arts, music, theatre, dance, creative writing and so on. They range across participation modes, such as a class or workshop where they are involved with the making of art and creativity themselves. It could also be more of a receptive experience going on a guided walking tour of an exhibition at an art gallery, museum or theatre.

There are many other variables as well. It gets to the right type of art for the right patient at the right time. Our technology is largely what makes that possible, and it connects patients with the highest efficacy arts engagement for them depending on their health status and particular needs, age and disease types.

CEOCFO: How were you able to put all of the pieces together to create the solution you provide? What are the different aspects and what is your involvement?

Appleton: Art Pharmacy is the enabler between a healthcare ecosystem here in the U.S. of third-party payers, providers and health systems, which are the doctors and members of care teams that write the prescriptions for arts and culture engagements. Then, the third-party arts and culture partners are your local museums, dance studios, painting studios, which are already providing these resources in their respective communities. Art Pharmacy is orchestrating that symphony of partners.

Art Pharmacy acknowledges that physicians have been referring patients informally out to community resources for a long time. Cultural institutions have provided programs and activities to support patient health for a long time also. They have historically not communicated with each other. Art Pharmacy’s platform enables the infrastructure of that ecosystem to work more harmoniously.

CEOCFO: Do people reach out to you or are you actively reaching out to the communities, physicians and payers?

Appleton: It goes both ways. Every day, we field inbound queries from all these different partner types that I just described. Every day, we are out there trying to build a larger network of stakeholders that are working to improve patient health and reduce the cost of care.

CEOCFO: Art Pharmacy serves patients in managed care programs (Medicaid, Medicare or Medicare Advantage), university and student health, health systems and providers, employer and commercial plans, and public health. How does this work?

Appleton: Art Pharmacy helps health plans and payers like Medicaid, managed care organizations, health systems and universities increase the availability of mental health services through arts-based social prescribing. Largely exacerbated by the pandemic, there is a significant imbalance between demand for mental health services compared to the availability of therapists, counselors, and other behavioral health providers.

Art Pharmacy helps payer partners, Medicaid, Managed Care organizations, and value-based Medicare providers, health systems, behavioral health providers and university student health plans receive a larger supply of mental health services into their network through this arts-based mental health approach.

CEOCFO: Your solution starts with a prescription. Where does it go from there for the patient? Is it telehealth driven, in person, a combination?

Appleton: After a patient is referred to Art Pharmacy by their primary care provider or behavioral health provider, that provider calls in the prescription to Art Pharmacy. It’s similar to your provider through electronic means with Walgreen’s or CVS. Through a telemedicine platform, the patient connects with an Art Pharmacy Care Navigator and completes an intake where we assess the patient’s mental health status and well-being. Then, we match the patient with the highest efficacy arts engagement for them. Those engagements are in-person, and we have virtual arts engagements available as well. We provide the patients with tickets or access to the arts engagement for patients participating in that activity with our culture partner.

We monitor their progress and track how a patient is doing and outside of the clinical setting. It is a closed-loop referral system. Art Pharmacy provides that data back to the referring provider, the primary care physician and health system. We provide updates on how the patient is doing outside of the clinical setting so the provider is able to monitor patient health and well-being between visits, which are oftentimes just once a year. Then, that process repeats the smart matching until the prescription expires.

Our standard prescription is six doses of arts and culture over six months. There are other treatment plans depending on what the patient’s need is.  

CEOCFO: Would you tell us about the arts partners that you refer patients to? Is there a vetting process? Is there some sort of certification needed? Big organizations or small groups?

Appleton: All of the arts and culture partners on our platform go through a vetting and onboarding process. All arts and culture partners have to meet the standard of care. There is a compliance and insurance protocol that they go through in order to be included in our database of arts and culture partners. The partners range from large institutions to smaller community-based organizations, along with individual arts and culture providers.

The reason we have diverse provider types or arts and culture partner types is to meet patients where they are in their health goals. Different patients respond to different arts engagements and different arts partners differently. The patient’s safety is most important.

CEOCFO: What are some of the benefits for the patient? Why would a payer and/or provider prescribe engagement with art over traditional solutions like counseling and drugs?

Appleton: Art Pharmacy is not an “instead of” solution. Art Pharmacy enhances and accelerates the quality of impact for a patient that may be in psychotherapy, on antidepressants or antianxiety medication. Anxiety disorders, depression disorders or social isolation and loneliness are serious issues in the US, especially amongst adolescents and older adults. We also work with chronic disease management programs.

Art Pharmacy improves compliance to patient treatment plans. Art Pharmacy boosts emotional wellbeing, reduces social isolation and loneliness to essentially reduce the cost of care for payers.

CEOCFO: How many states are you in currently and what is the plan to grow your footprint and reach?

Appleton: In 2023, Art Pharmacy will fill prescriptions for arts and culture in California, Georgia, Massachusetts and New York. We are in conversations to expand into other states as well. We have a plan for coverage across the United States.

CEOCFO: What is your role as CEO? Is it raising funds, creating awareness, managing the team, building relationships, business strategies, all of the above?

Appleton: I have the great privilege of working with an amazing team on the service delivery side, product side and patient engagement side. A big part of my role is managing and leading our team, ensuring that resources and partnerships are in place for us to successfully execute on our mission of improving patient health and reducing the cost of care.

I am also engaged in our business development by leading our business development activities with venture partners.  

CEOCFO: Did Covid and people spending so much time alone or cutoff enhance the need for your solution?

Appleton: The pandemic exacerbated a preexisting mental health crisis in the United States, especially amongst adolescents and older adults. Adolescents were already experiencing insolation because of social media and technology. Older adults were already at greater risk of loneliness, and the pandemic prevented all of us from being with loved ones.

The US Surgeon General also recognized the need for advancing initiatives to address loneliness. Social isolation and loneliness is a significant burden, not just on individuals, but on the health system and economy at large. That is what Art Pharmacy was developed to address.

CEOCFO: In closing, why is Art Pharmacy so important today? Are there other companies like you out there today or are you the first to develop such a platform?

Appleton: Art Pharmacy is unique in that we are working across a broad spectrum of payers, providers and arts and culture partners to improve patient health, compliance to patient treatment plans, and reduce the cost of care. We are grateful to be doing that in partnership with many individuals and organizations that have been working for a long time to achieve similar goals, but through different means. These organizations have long felt a solution like Art Pharmacy could make their job easier.

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