Originally published in The Tennessean, May 2023
A person’s emotional and physical well-being are one and the same. There’s a growing need for access to quality care in our society, and businesses have an opportunity to integrate mental health treatment into the broader health care system.
More people are struggling with anxiety, depression and stress, and these conditions have never been more relatable. Fortunately, many now feel they can be more open and comfortable discussing their experiences. While I’m thankful this stigma continues to erode, mental health statistics remain worrisome.
Only 56% of psychiatrists accept commercial insurance, compared to 90% of other types of health care providers. Meanwhile, nearly a million adults in Tennessee have a mental health condition.
For context, that’s more than 1.3 times the population of Nashville, and 5 times the population of Knoxville.
The fundamental driver behind these stats is inaccessibility to needed care. Simply put, there aren’t enough mental health providers. And most are concentrated in urban areas, often operating outside of the health insurance system.
Responding to a widespread need
BlueCross, like all insurers, is required to cover treatments for mental health, and we embrace this responsibility.
We recognize that finding high-quality care can feel daunting. It’s going to take every part of the health care ecosystem working together to make it easier.
That’s why it’s important to be transparent about the challenges with expanding access and some of the steps we’re taking.
We understand that mental health providers feel they aren’t paid enough, especially as many operate small practices. They may not have the office infrastructure or resources to easily work with insurers to check eligibility and file claims. To ensure our members can access a provider for the treatments they need, we’re committed to improving relationships with these providers.
This commitment starts with growing our commercial networks and dramatically increasing our reimbursement for psychiatrists, psychologists, and therapists. This will begin in fall 2023.
We’re also increasing access to digital care through programs like Teladoc, a telehealth option that allows for convenient, confidential mental health services from the comfort of members’ homes. Our “Find Care” provider directory tool has undergone recent updates to make it more user-friendly for those seeking behavioral health care.
We’ve changed our behavioral health case-management program to focus on scheduling appointments for members, working with providers to secure appointment times and appropriate follow-ups.
Case managers will be more closely aligned with our pharmacy team, using medication data to determine if a member fills a new prescription for a behavioral health medication. They can then engage with the member as appropriate through multiple channels to make sure the member takes their medication as instructed by their provider.
The first few weeks of these types of medication are critical, and our goal is to make sure the first refill is a success. That in of itself is a huge step.
Our recent Health Equity Report has helped us identify which ethnic groups are less likely to receive certain treatments and has aided our engagement efforts with these communities.
Partnership a priority
We’ll also work with the provider if a member complains of side effects that might keep them from taking their medications. These provider partnerships are vital: We all must work together to expand behavioral health care and ensure successful treatment. That’s why we’ll collaborate with providers to create a reimbursement system that rewards increased access, better quality metrics, and affordable outcomes.
We’ve also been working with Tennessee customers who want to help their employees remain physically and mentally healthy and engaged in their work. Workplace burnout, anxiety, and depression have all risen significantly. Employees are increasingly looking to employers to care not only about their productivity, but their mental well-being, as well.
If we all continue to engage, we’ll continue to erase that stigma and all be healthier as a result.
Scott is responsible for day-to-day management and operation of the state’s largest health insurer. He takes an active role in developing the long-range goals, plans and objectives of the organization, and leads operations teams including customer service, claims, clinical staff, provider networks, marketing, and information systems.