OCONOMOWOC – Rogers Memorial Hospital’s lakefront campus is a vestige of its founding as Oconomowoc Health Resort in 1907, when fresh air and the countryside were recommended treatments for people with mental illness, and hydrotherapy, such as bathing in spring water, was considered an innovation.
The hospital, tucked away on 82 acres on a back road in the Oconomowoc area, was a place where people of some means would be sent for treatment. And for most of its 110 years, the hospital drew little attention.
That began to change about 20 years ago.
The hospital is now part of Rogers Behavioral Health System, which also has hospitals in West Allis and Brown Deer.
Rogers Behavioral Health System provides care to more than 11,000 people a year, including more than 10,000 in the Milwaukee area. It employs about 2,000 people. And in the past five years, its revenue has doubled.
The behavioral health system opened its hospital in Brown Deer in 2015 and has steadily added new services at its hospital in West Allis. It also has expanded and added new services at its Oconomowoc campus.
And this year it joined with Ascension Wisconsin and Children’s Hospital of Wisconsin to submit a proposal to operate an acute-care behavioral health hospital that would replace the Milwaukee County Behavioral Health Division’s hospital in Wauwatosa.
Universal Health Services Inc., based in King of Prussia, Pa., a for-profit company that operates acute care and behavioral health hospitals throughout the country, has a competing proposal.
A decision is expected by the county this year.
Rogers Behavioral Health provides specialized, intensive care — as opposed to ongoing therapy — for complex patients with obsessive compulsive and anxiety disorders, depression and mood disorders, substance abuse disorders, eating disorders or post-traumatic stress disorders.
Its recent growth stems partly from changes in federal laws that require health insurers to provide the same benefits for behavioral health as for other medical care.
It also is driven by the increasing acceptance that behavioral health conditions, such as obsessive-compulsive disorder and bipolar disorder, are no different than other medical conditions, such as diabetes or heart disease.
That has helped lessen the stigma long associated with mental illness, resulting in more people seeking treatment. More effective treatments also have contributed to the increase in demand for behavioral health care.
Nationally, almost 10 million adults — or about one in 25 — have reported having a serious mental illness that affects major life activities, according to the Peterson-Kaiser Health System Tracker.
Rogers Memorial Hospital was founded by Arthur Rogers, who graduated with a specialty in psychiatry from Rush Medical College in Chicago. He converted the hospital to a nonprofit institution in 1935 in honor of his late wife, Theresa.
The hospital’s extensive gardens were started by Theresa Rogers.
In the early 1990s, the hospital was struggling and almost closed. David Moulthrop, a psychologist who retired as president and chief executive officer in 2012, is credited with the turnaround. During his tenure, the hospital began developing a reputation for treating people with eating disorders, such as anorexia and bulimia.
The focus on eating disorders enabled the hospital to brand itself, said Paul Mueller, CEO of the hospital division.
Rogers later built a reputation for treating people with obsessive-compulsive and other anxiety disorders.
The hospital opened clinics in Madison, Kenosha and Brown Deer. And in 1999 it bought a hospital in West Allis that Charter Behavioral Health Systems, a chain of psychiatric hospitals and treatment centers, planned to shut down.
The finances of the hospital — later renamed Rogers Behavioral Health System — steadily improved. By 2014, it was able to raise money by selling $53 million in bonds.
The proceeds gave Rogers Behavioral Health the resources for an ambitious strategic plan put in place by Pat Hammer, who became CEO in 2012.
In recent years, it has opened its hospital in Brown Deer, opened a clinic in Appleton and expanded its Oconomowoc and West Allis hospitals. It also began opening clinics in other states in 2014 and now has clinics in Tampa, Fla.; Chicago; Minneapolis; Nashville, Tenn.; and Philadelphia.
Rogers plans to open a clinic in Walnut Creek, Calif., in the San Francisco Bay area, early next year, and it tentatively plans to open two new clinics a year for the next few years.
The system’s treatments are standardized, enabling the same model to be used in each new clinic, Hammer said. The clinics are designed to treat about 60 patients a day when fully staffed.
The burst of growth is reflected in the health system’s finances.
Rogers Behavioral Health had revenues of $150 million in its fiscal year ended July 31, 2016 — a 21% increase from its revenue of $115.6 million in the previous fiscal year and more than double its revenue of $69.4 million in the 2011 fiscal year.
Rogers posted net income of $12.9 million for the 2016 fiscal year.
The behavioral health system provides residential, inpatient, partial hospitalization and intensive outpatient care.
Residential stays are for 30 days or more — the typical stay is 45 to 60 days — and an average of roughly 160 patients are in its residential treatment programs on a given day.
The behavioral health system’s programs have a strong emphasis on what is known as cognitive behavioral therapy — a type of psychotherapy that works to identify unhealthy patterns of thought and how they can result in self-destructive behaviors and beliefs.
The goal is to instill alternative, healthier behaviors and thoughts through repetition, said Brad Smith, a psychiatrist who specializes in eating disorders at the Oconomowoc campus.
“That’s typically the best we have for any type of distorted thought,” Smith said.
The health system also has an expertise in what is known as exposure and response prevention, in which patients are gradually exposed to feared situations that cause anxiety and trigger a response. A patient with a fear of germs, for example, may be asked to hold a doorknob for an increasing period of time.
The therapy, a component of cognitive behavioral therapy, is considered the preferred treatment for obsessive-compulsive disorder. It also is being used to treat other conditions, such as phobias and anxiety disorders.
The health system discloses the outcomes for its programs. It also has worked to standardize its treatment programs to ensure that they follow what are considered the best clinical guidelines.
Both tasks are eased by its $10 million investment in a system for electronic health records. It worked with Cerner Corp. to develop a behavioral health module for the company’s system for electronic health records.
The behavioral health system’s psychiatrists, psychologists and other clinicians also are involved in numerous research projects.
Today, 90% of the residential patients have some insurance coverage, and 75% of the patients are approved for coverage for their entire stay. Some decisions to end coverage also are overturned on appeal.
Rogers Behavioral Health in the past was criticized for treating few patients covered by Medicaid. That changed with its hospitals in West Allis and Brown Deer. About a third of its patients now are covered by Medicaid, and about 7% are covered by Medicare.
It also accepts referrals when the Milwaukee County Behavioral Health Division’s hospital in Wauwatosa is at capacity. Those have totaled more than 7,500 — an average of about 500 a year — since 2002, said Mueller, who oversees the health system’s hospitals.
Without question, Rogers Behavioral Health faces the same challenges as other systems that treat complex patients with serious behavioral health conditions. The stigma associated with mental illness remains. And the shortage of psychiatrists and other clinicians has become a crisis.
Recruiting staff could slow its planned growth. But the behavioral health system has some advantages in recruiting psychiatrists and other clinicians. For one thing, they can work closely with other specialists.
“That’s one of the big attractions for psychiatrists and physicians working here,” Smith said.
The demand for specialized behavioral health care also is projected to continue to grow. “That’s our sweet spot,” Hammer said.
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