With approximately $5 billion worth of state cuts in mental services from 2009 to 2012, the elimination of nearly 4,500 public psychiatric beds during the same time period, and a shortage of behavioral health providers, it is no surprise that many Americans with serious mental illness aren’t getting the care they need.
They aren’t just falling through cracks here and there; they’re tumbling through gaping holes in system that’s broken.
All of these concerns—along with the significant impact of mental health and substance use disorders on patients, society, and the economy—seem to have moved insurers into assuming the very unlikely role as innovators in behavioral health care.
A report released last month by the America’s Health Insurance Plans (AHIP) chronicles case studies on the efforts of health care plans are making beyond the parity requirements of the Mental Health Parity and Addiction Equity Act (MHPAEA). Anthem, Cigna, and HealthPartners are among the insurers whose efforts are described by AHIP. One program that caught my eye was the “Make It OK” campaign, an anti-stigma campaign piloted by HealthPartners in partnership with a local public television channel and chapter of the National Alliance on Mental Illness (NAMI). The goal is remove any sense of shame that might keep people from seeking treatment for mental health problems and accessing benefits that will help pay for those services. HealthPartners also uses a predictive algorithm and claims data to identify individuals likely to be hospitalized with mental health crises, conducts an annual member satisfaction survey to evaluate access to behavioral health clinicians, and offers online behavior therapy for members and employees.
For some time now, advocates for improving the nation’s mental health system have pointed out the flaws of carving out coverage for behavioral health. They have argued for a more holistic approach that would remove the artificial barrier between behavioral health care and the rest of the health care system and have suggested a move toward value-based care in alignment with the rest of the system.
Although it may take some time before we see measurement-based care in mental health, I see a trend toward wider adoption of the kind of programs that these insurers are trying.
The holes of the behavioral health system are far too large to fix quickly. But we’re getting there.