A growing crisis: Top strategies for payers to address behavioral health access, costs and utilization

Engaging individuals who suffer from behavioral health issues, so that they can be guided to the best care and providers, is a challenging task for health plans. Success often depends on luck in having them pick up the phone and stay engaged long enough to see results. But a tech-enabled approach can help.

This was a major theme in a panel discussion about behavioral health solutions at Becker's Payer Issues Roundtable, led by Mary Lou Osborne, president and chief commercial officer of Ontrak, featuring other Ontrak leaders, including:

  • Judith Feld, MD, chief medical officer 
  • Rick Newman, senior vice president, business development and customer success

Three key takeaways were:

1. People with behavioral health conditions have a hard time knowing where to begin to seek care and treatment for their health care. Over 50 million Americans are suffering from a mental illness and nearly half aren't receiving any treatment due to stigma, high costs or inability to find or be matched to the right provider. Many others who start receiving care do not always follow through to completion. " Behavioral Health is challenging for members to navigate, that is why at Ontrak Health, we make it easy with a proactive, personalized approach for members. " Ms. Osborne said.

2. Ontrak uses augmented intelligence technology to engage members in a personalized, consistent, scalable way. This tech-enabled behavioral health company:

- Uses predictive analytics to identify members at high or rising risk of behavioral health conditions and imputes probable behavioral health diagnoses from member claims data.
- Prioritizes members according to readiness to engage, contactability and other factors.
- Optimizes the contact window for engaging those members.

Based on an internal study of 6,000 Medicaid plan members, Ontrak increased engagement by 23% by pinpointing how to engage the right people at the right time in the right order.

Ontrak's member engagement team is trained in motivational interviewing and also has AI audio virtual assistant capabilities available. "Once we have a member on the phone, 48% of the time we are able to enroll the member into the program," Mr. Newman said, noting the industry average is about 35%.

3. Ontrak's coaching program is the culmination of its optimized engagement capabilities. The goal of engaging members with behavioral health issues is to meet the member where they are in their health care journey and direct the members to the most appropriate care for their conditions.

Ontrak's approach is to provide members with personalized care coaching, staffed with licensed clinicians and Health and Wellness Coaches. Once members are enrolled in the program, 60% stay for more than six months and 55% stay for a full year.

In addition to care coaches, Ontrak has contracts with behavioral health providers that are affiliated with the respective health plans. "We have our own contractual relationships with providers because we want to make sure members are being seen in a timely manner, that the treatment is working for them and that our coaches are receiving information from the provider on the members’ treatment plans," Dr. Feld said.

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