| Many of your most challenging claims and cases likely present a behavioral health component. BHM offers a reviewer network with the most sub-specialties. 6 of the top 10 largest health plans entrust BHM for behavioral health peer reviews. CLICK HERE to learn more about how BHM helps your organization curb behavioral health costs. |
Managing behavioral health costs challenges the US healthcare system. The issues encompass many of the legacy processes and structures needing to be overhauled. Some interesting recently posted examples may show the way for the entire healthcare system. These come from both payers and providers.
St. Joseph Medical Center
A Modern Healthcare article, suggests using community health workers to reduce readmission rates. At the University of Maryland St. Joseph Medical Center, a 232-bed hospital in Towson, a quarter of high-risk patients were hospitalized again within 30 days. So the hospital began deploying community health workers tasked with helping these patients address pressing nonclinical issues after they leave the hospital.
“You cannot underestimate the importance of addressing the psycho-social needs of patients upon discharge,” said Dr. Gail Cunningham, St. Joseph’s chief medical officer. “The best medical plan in the world is going to fail if some of the patient’s basic needs aren’t met.”
In its first 16 months, readmission rates for patients enrolled in the program dropped by 60%. In May, about 10% of St Joseph’s high-risk patients were readmitted within 30 days, compared with 25% when the hospital launched the program in February 2015.[email-download download_id=”68025″ contact_form_id=”68022″]
Ensuring Access to Quality
America’s Health Insurance Plans (AHIP) released a white paper, Ensuring Access to Quality Behavioral Health Care: Health Plan Examples. 11 health plans outline their efforts. The paper concludes:
Health plans are successfully collaborating with providers and consumers to help facilitate access to coordinated, affordable, evidence-based behavioral health services. Ongoing challenges, which may benefit from policymaker attention and potential policy solutions include:
- Implementing new workforce programs to address widespread shortages of behavioral clinicians, such as psychiatrists and psychologists who specialize in caring for children and teens;
- Addressing barriers to more widespread use of telemedicine which can augment provider capacity and improve consumer convenience; and
- Allowing for substance use diagnosis and treatment information to be securely shared among providers to support care coordination and quality.
Health plans recognize the importance of behavioral health care. In addition to meeting parity requirements, plans are proactively engaging with consumers who need behavioral health care, coordinating their care across the continuum, and working with them to find community-based support services they may need.
Many of your most challenging claims and cases likely present a behavioral health component. BHM offers a reviewer network with the most sub-specialties. 6 of the top 10 largest health plans entrust BHM for behavioral health peer reviews. Click HERE to learn more about how BHM helps your organization curb behavioral health costs.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
