Where 3 payers are investing in behavioral care networks

Payers are continuing to expand their mental and behavioral care provider networks in response to the growing need nationwide for services.

Becker's asked three payers the following question: Where is your organization investing or directing resources to improve member access to behavioral healthcare?

Brooke Tomblin. Clinical Program Director of Health Equity and Language Services at Cigna (Bloomfield, Conn.):

Cigna provides a comprehensive offering that spans the spectrum of support — from network, access, and utilization management to intensive coaching. Powered by our Evernorth Behavioral Health network, our customers have access to nearly 250,000 contracted health care professionals and facilities nationwide, dedicated to helping them improve their well-being and navigate issues such as loneliness, stress, depression, anxiety, and substance use disorders. We also have one of the largest virtual care networks in the country, allowing customers to gain support when and wherever they need it. Through predictive analytics, we can also identify and engage at-risk individuals early. 

Our virtual care providers like Ginger, Talkspace, Meru Health, MAP Health Management, Monument, Bicycle Health, Alma and NOCD (to name a few) bring mental healthcare and support directly to customers in easy, convenient ways like text messaging or video chat to meet customers where they are. These providers can help prevent the onset of serious illness or provide more acute care for specific conditions such as anxiety or depression. In directory tools, customers can select a provider based on race, gender identity, and sexual orientation.

Oleg Tarkovsky. Director of Behavioral Health Services at CareFirst BlueCross BlueShield (Baltimore):
We've prioritized increasing access to mental health services for our members by:

  1. Forging partnerships with companies like Headway, which use technology to remove barriers faced by providers, payers and members.
  2. Creating, co-creating or partnering with innovative companies like 7 Cups, CloseKnit, Live Chair Health and Even Health to support behavioral health access and care delivery through methods like telehealth, virtual support and meeting members where they are in the community.

We also are examining ways to expand the behavioral health workforce to ensure we have a diverse slate of behavioral health providers to meet demands, including those in rural and underserved communities. 

In the public sphere, CareFirst has been working to encourage federal, state and local governments to expand support of telehealth and behavioral health capabilities. We encourage government policymakers to support and support embedding behavioral healthcare practitioners into primary care practices. 

Lastly, aligning with our not-for-profit mission, we are preparing to announce our latest round of $4.8 million in grants earmarked for community organizations focused on improving behavioral health outcomes through increased access to services for youth and workforce development for all populations.

Vanessa Bobb, MD, PhD. Vice President of Behavioral Health and Medical Integration at CDPHP (Albany, N.Y.):
Recognizing the increased demand for behavioral healthcare services, coupled with a shortage of in-person, local providers, CDPHP has worked tirelessly to improve and expand access to critical mental telehealth and substance use services for our members, particularly children and adolescents. Telemedicine providers, including CDPHP partners Aptihealth, Doctor On Demand and Valera Health, are well positioned to meet the demands for behavioral health services for these age groups. CDPHP also conducts frequent outreach to our members, utilizing a multichannel approach that includes partnering with CDPHP pediatric care managers, school districts, and community-based organizations with a focus on expanding access to high-quality, timely children's BH services.

Investing in behavioral health resources will continue to be a top priority for CDPHP heading into 2023. We removed the cost-share for many plan products for mental health and substance use support from a smartphone, tablet or computer with Aptihealth, including personalized therapy for members ages 5 and above. Cost-share for Doctor On Demand for most plans was removed in 2022. In addition, for our adult members, CDPHP partnered with a local hospital to sponsor a crisis de-escalation center. In less than four years, the Living Room project served nearly 3,500 patients, with a 98 percent ER diversion rate, saving an estimated $4 million, and referred more than half of those patients to ongoing mental health treatment.


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