How Payers Can Enable Behavioral, Physical Care Integration
The healthcare system is in the process of pivoting from decades of siloing to behavioral and physical care integration, and payers can be part of the key to success.
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- Brett Hart, chief behavioral health officer at Centene, and Indira Paharia, chief operating officer for behavioral health at Centene, are very familiar with the need for behavioral and physical care integration.
At Centene, approximately nine of the top ten diagnoses for telehealth encounters were related to behavioral healthcare, according to a report. As the demand for behavioral healthcare continues to grow, the ways in which behavioral and physical healthcare influence one another become increasingly evident.
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Nevertheless, integration remains a daunting task. The behavioral healthcare problems that plague the modern-day healthcare system have roots in decades-old patterns, according to Hart.
“It is important to really rewind a bit and look at the history of behavioral health as it has existed over the last 30, 40 years--and even persisted into the last few years. That's a history marked by behavioral health being carved out of most health plans and being disconnected and fragmented,” Hart told Healthcare Strategies.
“Once this trend began to shift, and large insurers began to carve behavioral health in, many of them encountered issues with a lack of shared platforms, a lack of common language, disconnected workflows, and--quite frankly--an uncharted roadmap toward collaboration.”
However, even when payers pave a pathway for collaborative care, they may face obstacles to integrating behavioral and physical healthcare, Paharia added in her conversation with Healthcare Strategies. The changes to providers’ workflows can be radical and overwhelming for practices to handle.
“We have a model called the collaborative care model that is showing some promise and there were codes that were established for that model,” Paharia explained.
“But even though those codes exist and they were supported by Medicare and are now being added into Medicaid, providers aren't necessarily using those. That really goes back to Brett's point about the huge overhaul and transformation of a practice to be able to even operate that way, to bill for those collaborative care codes.”
Hart and Paharia emphasized that addressing mental health substance abuse integration was the first step toward overall behavioral healthcare integration into physical healthcare and primary care services.
Payers also should consider how they use technology to improve access to care--such as through telebehavioral health platforms--and how they can channel real-time information to providers.
For example, as a step in this direction, Centene recently announced that it intended to acquire Magellan Health, a behavioral health platform, to address the high demand for access to behavioral healthcare.
As payers move towards further integration of behavioral and physical healthcare, building in quality measures and standards of care for integration will be key. For that, they should rely on value-based care strategies in addition to their telehealth platforms, Hart recommended.
“Value-based care is really another wonderful tool in the toolbox,” Hart said.
“Our goal in using value-based arrangements is to reduce the administrative burden on providers, and really equip them with the tools designed to create visibility regarding patient progress and regarding gaps that may need to be addressed.”
