Addressing the affordability of behavioral health care and taking advantage of technological tools will significantly improve the utilization of behavioral health care, according to several behavioral health experts who discussed the topic at our 2022 Arizona State of Reform Health Policy Conference.
One of these experts, Corporate Medical Director of Integrated Care at Blue Cross Blue Shield of Arizona, Sandra Zebrowski, MD, said Arizona has a higher rate of completed suicide per 100,000 people than the national average. For children and youth, between 2017 and 2019, the annual average surveillance of serious thoughts of suicide in Arizona for ages 16 to 25 was higher, at 11.5%, than the regional and national average.
However, the number of people in the state accessing behavioral health care remains low, despite heightened needs resulting from the COVID-19 pandemic. She said the high cost of behavioral health care in the state is often the main hindrance to people accessing this care.
“A part of making health care more affordable for everyone is being able to adequately address behavioral health concerns,” she said. “Co-payments are not zero in commercially-insured plans. You can’t just have one visit and be done, it is, generally speaking, a commitment for a period of time. Those co-payments add up for individuals, [as well as] the time it takes to travel [to those appointments] and care for family.”
The experts also noted that overall health care spending will decrease if individuals are effectively treated for behavioral health conditions.
“In terms of the number of chronic conditions, if you add 1 behavioral health condition, you increase the cost of care by as much as 305 to 1,” Zebrowski said.
She said that in order to increase the affordability of behavioral health care in the state, the care system needs to increase the interfaces that people are able to engage with, such as through telehealth and other digital solutions.
“We have to do a better job of engaging people into a hopefulness about what mental health and behavioral health treatments can offer them … At Blue Cross alone, we find that more than 57% of our behavioral health visits are happening through telemedicine, and that people in general are 85% satisfied with that method of receiving treatment. We have had an overall increase in utilization of behavioral health.”
Shar Najafi-Piper, CEO of Copa Health, emphasized the importance of making telehealth accessible according to the specific needs of an organization’s members.
“In our organization, we serve the complex members,” she said. “These are members with serious mental illness, these are members with medically fragile conditions, these are members with developmental disabilities … It’s really important to talk about ways in which you’re creating the digital format by way of [your organization’s] capabilities. You have to have tech literacy advances at your organization, so that means get to know your membership and understand what feels good to them as it relates to technology.”
She also highlighted the need for provider groups to be more efficient with the technological tools that are available to them in order to continue to be able to meet growing demand, specifically citing her organization’s risk stratification protocol system.
“It does not mean this is the only way in which you assess risk,” she said. “But it’s a starting point, that coupled with some clinical judgment, allows you the opportunity to know how long you see members and behavioral health, so that you allow for that influx of new referrals coming into the system.
Oftentimes, in provider groups, we are sort of reactive to those tools. I highly encourage them to be proactive and utilize those tools as much as you can. [It’s about being] able to talk with your clinicians about, what does it mean when somebody is at the highest acuity of risk? How often do we see them, and for how long do we see them? [And we use this protocol] almost as a utilization management process to be able to really meet the need of the membership that we serve, but do what’s best for them, not just what we think is best for them.”