5 Ways Payers Have Tackled Mental, Behavioral Healthcare in 2021

Lowering hospital readmissions

Hospital readmissions can have negative impacts, both for the healthcare system and for patients. They are very costly and tend to worsen patient outcomes.

Blue Cross & Blue Shield of Rhode Island (BCBSRI) aimed to reduce hospital readmissions for members with behavioral health conditions in order to avoid these negative consequences. The payer partnered with a local hospital in order to give members a smoother transition from the inpatient setting to an alternative site of care.

The program offers members counseling and medication management assistance to help members maintain their treatment. Additionally, members receive case management support upon discharge.

The partners aim to hospital readmission in the first 30 days after discharge by five percent.

Balancing in-person, virtual behavioral healthcare

During the coronavirus pandemic, non-urgent in-person care was limited. Members turned to telehealth and virtual care solutions in order to access mental healthcare support. However, as in-person care becomes more widely available, payers have to consider how to integrate their in-person care with the virtual care options that members grew to appreciate.

Aetna and CVS Health introduced virtual care for mental health that mirrors their in-person HealthHUB treatment options.

The payer launched a pilot program that employed clinical social workers to conduct mental health assessments, offer mental healthcare referrals, and more at HeathHUBs in Houston, Philadelphia, and Tampa.

Concurrently, CVS Health started constructing a virtual care option that provides the same mental healthcare resources. Ultimately, members will be able to have some fluidity between the two modes of care. Aetna executives expected that this approach would allow for greater personalization in the payer’s mental healthcare approach.

Educating providers

Providers may see a wide range of mental and behavioral healthcare conditions. If they are not trained in mental and behavioral healthcare, they may not know the best way to support their patients. This can be particularly detrimental for patients who are struggling with suicidal thoughts.

In light of this, Aetna aimed to improve its members’ access to mental and behavioral healthcare by educating its provider partners.

The payer partnered with a platform that educates providers on behavioral healthcare, with an emphasis on suicide prevention. Around 283,000 providers including behavioral healthcare professionals and licensed clinical social workers can access evidence-based suicide prevention tools and resources for free.

Increasing access to information

While some payers like Aetna focused on educating providers about evidence-based behavioral and mental healthcare treatment, others helped members stay informed about their behavioral and mental healthcare treatment options.

Blue Cross and Blue Shield of Florida (Florida Blue) partnered with a nonprofit and a behavioral healthcare organization to give members access to behavioral healthcare provider data.

The partners formed a database that details substance abuse treatment providers’ techniques for substance abuse care. Members can find a provider through a targeted search. They may filter by location, services, and insurance type.

The tool will require significant payer-provider partnership, as the data must be acquired and distributed with the providers’ consent.

Beyond supporting members’ decision-making, the platform may also be informative for the policymaking process as local and national leaders formulate regulations and programs related to substance abuse.

Providing social connection

Seniors were particularly susceptible to coronavirus and, as a result, many remained socially isolated for months at a time. Social isolation can have both physical and mental health implications leading to higher healthcare spending.

To help seniors cope with loneliness and improve their mental health, SCAN Health Plan initiated a program that increased seniors’ social connection.

The program, which the payer launched in May 2021, includes both virtual and in-person classes and activities. Seniors can also join a program that connects them with the payers’ employees and peer advocates to enjoy a phone conversation. Lastly, seniors can access technical support so that they can connect with family and friends.

By connecting members with peer advocates, seniors may become more physically active and address mental healthcare needs.

As 2021 progresses, payers will continue to develop their strategies around mental and behavioral healthcare to support members in the wake of COVID-19.