Consumer access to care remains a ‘top of mind’ issue—from access to psychiatrists, waiting lists for treatment programs, and follow-up appointments with therapists—executives realize that care delayed is often never received, which can lead to more expensive care.
In 2017, only 48.2% of members with a commercial HMO plan had a follow-up visit within seven days after discharge from the hospital for mental illness (see Follow-Up After Hospitalization For Mental Illness). And just 37.0% and 32.2% of consumers who have Medicaid and Medicare coverage had follow-up visits within seven days post-discharge, respectively. Only 37.1% of adolescents or adults with episodes of alcohol or other drug dependence who had commercial insurance initiated treatment within 14 days of diagnosis (see Initiation And Engagement Of Alcohol And Other Drug Abuse Or Dependence Treatment). For consumers with Medicaid and Medicare, 42.4% and 32.6% initiated treatment within 14 days, respectively.
We wanted to know what health plans are doing to address this access issue and surveyed more than 4,000 U.S. health plans to get answers. We learned that there are three overarching initiatives to improve consumer access to care—telehealth (increasingly referred to as virtual care, a more expansive term embracing all the technologies deployed to support behavioral health), targeted specialty network expansion, and supported consumer appointment scheduling.
Telehealth—The delivery of health care services remotely through telecommunications technology is the most widely used strategy across health plans to improve access to care. Ninety-six percent of health plans have adopted telehealth including 68% of commercial plans, 98% of Medicaid plans, and 99% of Medicare plans, according to Trends in Behavioral Health: A Population Health Manager’s Reference Guide on the U.S. Behavioral Health Financing and Delivery System. Plans are partnering with telehealth companies to build or expand service offerings and purchasing telemental health companies to expand access. And looking ahead, 66% of plans have some form of text-based therapy on their roadmap.
Targeted network expansion—Connecting consumers with the right type of therapists is one of the challenges with consumer access to care. Health plans are selectively recruiting new provider organizations for their networks that can provide applied behavioral analytics (ABA) and medication-assisted treatment (MAT) for addiction. Eighty-four percent of all health plans, 68% of commercial health plans, 97% of Medicaid, and 98% of Medicare have adopted MAT. ABA, or the process of systematically applying interventions based upon the principles of learning theory to improve behavior, has been adopted by 80% of all plans, 67% of commercial plans, 91% of Medicaid, and 92% of Medicare plans.
Supported appointment scheduling and ‘quick access’ initiatives—This is a popular approach to addressing access with 78% of health plans supporting initiatives to assist consumers and 70% of plans creating a ‘rapid access’ network or initiative (see ‘Rapid Access’ Might Just Be Your Next Health Plan Conversation).
To learn more on health plan initiatives related to access, innovation, consumer engagement, and more—check out the full results of our survey, published in the newly-released 2019 national survey of health plans, Trends in Behavioral Health: A Population Health Manager’s Reference Guide on the U.S. Behavioral Health Financing and Delivery System. And for more on increasing access as well as drafting a strategic plan to include increased access, check out these resources from the OPEN MINDS Industry Library:
- Untangling The Access Issues For Addiction Treatment
- Health Insurance Coverage Vs. Access To Care—The Gap Between Them
- If There Are Enough Psychiatrists, Why Is Access Such A Problem?
- Is Tech The Solution For The Behavioral Health Access Issues?
- Is 2019 The Year Of The Telehealth Tipping Point?
- Network Adequacy Doesn’t Equal Consumer Access
- For Health Plans, Technology = Improved Consumer Access
- The Strategic Planning Edition: Going From Strategy To Success
- Building & Executing Strategy In A Complex Market-A Three-Phase Best Practice Model For Success
- Jumping The ‘Strategy-To-Execution Gap’?
And for the payer perspective on tech-enabled health plan initiatives, join me in Philadelphia at The 2019 Technology & Informatics Institute on October 29 for the keynote address, Leveraging Technology To Expand Access, Enhance Consumer Experience & Improve Outcomes In A Behavioral Health Care Marketplace Dominated By Value-Based Models featuring Alison Nelson, Senior Vice President for Optum Technology, Optum.