Articles by Patrick Runnels, MD, MBA

Payer delays and unpredictable coverage stall mental health meds, worsening symptoms, work performance, and ER risk while forcing clinicians into inefficient trial-and-error care.

Clinicians weigh generics versus new psychiatric meds, emphasizing evidence for treatment-resistant cases, staying current, and balancing costs, side effects, and whole-person care.

Clinicians weigh generics, formularies and breakthrough psychiatry meds, from clozapine to esketamine, to treat resistance while managing costs, risks.

Clinicians unpack why meds fail—patient fit, side effects, and adherence—and share practical ways to boost understanding and remission.

Clinicians battle insurance formularies, using evidence, step-therapy strategy, and two‑week outcome tracking to secure affordable psychiatric meds.

Clinicians navigate insurance formularies, prior authorizations, and step therapy—using 14‑day check-ins and PHQ‑9 data to win better meds.

Clinicians weigh antipsychotic choices with patients, tracking labs and side effects, while navigating insurance and brand-vs-generic variability.

Experts reveal how stigma, misdiagnosis, and cost barriers delay depression, bipolar, and schizophrenia care—and what breaks the crisis cycle.

The panelists examined how the scarcity of mental health specialists creates a cascading effect on care capacity, where patients who do not respond to initial primary care treatment face an increasingly narrow pool of expert clinicians equipped to manage complex, refractory cases.

The panelists highlighted how stigma, misdiagnosis, and the concentration of mental health care in primary care settings collectively contribute to significant delays in patients receiving appropriate psychiatric treatment for MDD, bipolar depression, and schizophrenia.

Assertive community treatment, a strongly evidence-based practice for delivering care to individuals with schizophrenia and low health care engagement, is applicable to disengaged, medically complex patients.

Longitudinal, Relationship-Based Case Management: A Prospective Cohort Trial
ByPatrick Runnels, MD, MBA,Ryan Muskin, MA,Mark Votruba, PhD,Peter J. Pronovost, MD, PhD,Afua Ansah, BA,James Penman, LPCC A longitudinal, relationship-based case management approach significantly reduced health care costs and improved quality of life for Medicaid enrollees with complex needs over 1 year.

Eliminating Defects in Value: Turnaround of an MSSP ACO
ByPeter J. Pronovost, MD, PhD,Patrick Runnels, MD, MBA,Mark E. Schario, MS, RN,Tomasina Green, MPH,Kelsey A. Fuller, MS,Heather M. Byrne, MPA-HSA, CNMT,Valerie Reese, MEd,Tyler D. Barnett, MHSA,Kaitlin Mabin, BA,George Topalsky, MD A health system transformational leadership framework and management system made visible and eliminated defects in value and was associated with reduced annual Medicare expenditures and increased quality between 2017 and 2020.