Key Takeaways
- BlueCross understands that physical health and mental health are inseparable.
- In 2023, BlueCross reorganized care teams to better address members’ mental health needs.
- BlueCross is using member outreach to improve mental health outcomes and reduce costly medical events.
A high-risk pregnancy can be an extremely stressful experience that lasts for months — and not surprisingly, many expectant mothers with these pregnancies can also experience mental health issues like stress, anxiety and depression. That’s why BlueCross includes a behavioral health clinician as part of its maternity care program for Commercial plan members.
This is just one example of how we’re “baking in” mental health resources to many of our programs.
“You can’t separate physical health from mental health; they go hand in hand,” says Patricia Jones, BlueCross director of clinical strategy. “And it’s not just maternal health.”
“When someone has a chronic health condition, they’re at a significantly greater risk of developing mental health issues. And those with mental health conditions are less likely to manage their physical health effectively.”
Health for the whole person
For years, BlueCross has provided mental health resources for our members — we established our in-house behavioral health department in 2016 — but we recognized the need to do more. Earlier this year, we integrated behavioral health professionals into our care management teams who serve our Commercial members. These members with a variety of conditions like diabetes, heart failure and cancer all have licensed behavioral health managers as part of their support team.
“The restructuring allows us to better serve each member as a whole person,” Patricia says. “And it enables having discussion with members about mental health issues in a more seamless way. The behavioral care managers are just another part of the care team.”
Unfortunately, some people still have negative connotations around mental health.
“We work hard to combat that,” says Tabitha Miller, behavioral health manager. “Being part of the support team normalizes things.”
“We can just introduce ourselves as the behavioral health clinician on the team. We’re just another person there to check on them. It puts people at ease, which allows us to better serve them.”
This approach also helps us identify things early and work to prevent more serious and costly events like emergency room visits and hospital readmissions.
“For example, if a person with diabetes gets overwhelmed trying to manage their blood sugar and becomes depressed, they may become less concerned with managing their condition and end up in the emergency room due to their blood sugar level,” Tabitha explains.
Conducting outreach, promoting health equity
BlueCross leverages technology to identify potential issues by using claims data and predictive analytics. We then reach out to members to conduct mental health assessments.
As part of our efforts to promote health equity, we monitor mental health screenings by race. Our recent health equity report found that white members were more likely to receive screenings for antidepressants and antipsychotics than other races. We’re sharing that information with providers to help deliver better health for everyone, regardless of background.
More accessible mental health care
For members who may need counseling, BlueCross connects them with providers, either in person or virtually.
“While we’re licensed behavioral health workers, we don’t provide treatment services,” Tabitha explains. “However, we can help connect them with providers to get scheduled for care.”
To increase access to providers, we added the telehealth platform Teladoc, which makes 5,000 additional mental health providers available to Commercial members online. We’ve also increased reimbursement rates for in-network mental health providers to encourage more participation in BlueCross networks.
Improving prescription compliance
When patients receive a new prescription for an antidepressant, half of them prematurely stop taking it. BlueCross created an outreach pilot program to address the issue.
As part of the program, a BlueCross team of nurses, a pharmacist, and a pharmacy technician contact members during the early treatment phase to educate and support them in staying on and refilling prescriptions.
Alisha Moore, BlueCross total health management programs and operations manager, says, “Our program is focused on the first 30 days of compliance. During the first 30 days, the body is adjusting to the medication and it can actually make you feel worse. Some members conclude that the medicine isn’t working or isn’t right for them. We’re here to help them trust the process so it can take them where they need to be in their health journey.”
As part of our process, we ask members how the medicine is making them feel, if they experience side effects, and if they intend to refill it as recommended by their provider.
“We make sure they know they can talk directly to the pharmacist to get all their questions answered and understand the importance of getting that next refill,” Alisha adds.
Our newfound focus
Through these new efforts and initiatives, we’re better serving our members as one team — from a mental and physical standpoint.
“We’re wrapping our arms around the member fully,” Patricia says. “It’s total health. You can’t be a totally healthy person if you’re depressed and have anxiety. We’re committed to helping our members get where they need to be.”