Employer-provider partnerships can help us solve the nation’s behavioral health crisis
During the pandemic, employers took bold steps on mental health education. Now they have an opportunity to continue this important work.
Long before COVID-19, mental health was a serious concern for employers and a major cost driver. According to the Centers for Disease Control and Prevention depression caused an estimated 200 million lost workdays each year at a cost of $17 billion to $44 billion to employers. The pandemic escalated the crisis, as levels of depression, anxiety and other mental health concerns skyrocketed the past year.
Yet there may be a silver lining. In an effort to support their employees throughout the pandemic, many employers have redoubled efforts to support behavioral health and reduce the stigma associated with seeking care. Meanwhile, the Council of Accountable Physician Practices, a coalition of leading medical groups, and the National Alliance of Healthcare Purchaser Coalitions have brought together self-insured employers and providers for a series of discussion forums. Together, these stakeholders brainstormed long-term solutions to improve care, including mental health care.
Related: Behavioral health: The hidden chronic condition costing you millions
In our fragmented health care system, employers seldom have the opportunity to confer directly with providers, those on the front lines of caring for their employees. Communication can often feel like a game of telephone with health plans playing middlemen. These discussion forums generated many promising and innovative solutions to improve behavioral health. As we deal with the aftermath of the pandemic and look toward the future, employers would be well served to continue a direct dialogue with providers, working together to implement the solutions they identified.
These employer-provider partnerships could shape how best to integrate behavioral health into primary care. Not only would such integration have the potential to improve care and timely access for employees, but it could also reduce the headache for employers who often manage multiple and diffuse mental/behavioral health vendors. If behavioral health care was integrated into primary care, the primary care physician (and pediatric, ob-gyn and chronic care physicians) could start the patient on the right care path simply by asking the right questions. Take depression as an example, if a concern is identified, the physician can then make a warm hand off to a behavioral health specialist. Integrating behavioral health into primary care would also help to reduce the stigma associated with behavioral health.
During the pandemic, employers took bold steps on mental health education to reduce the stigma for employees who were suffering from anxiety, stress, depression and grief. Employers and providers have an opportunity to continue this important work, teaming up to educate employees about the signs, symptoms and treatment options in mental health.
Some employers are taking this one step further, testing employee assistance programs with the medical side of benefits. They are leveraging telehealth consultations to get employees direct access to providers to address mental health concerns. The continued use of telehealth to improve access to care of all kinds is another area for employer-provider support. During the pandemic, regulations on access and reimbursement rates for virtual care were adjusted to enable patients to receive care remotely. Long term, these policies must continue.
Finally, if employers and providers are going to successfully work together to improve behavioral health, they must team up to promote payment reform. In a fee-for-service environment, a physician is not compensated for the time it takes to really talk to a patient to identify behavioral health concerns. But payment arrangements like capitation give providers the freedom to truly manage a patient’s overall health — which should include behavioral health.
The National Alliance and CAPP believe in and support integrated health care. We want providers to think holistically about a patient’s needs and bring a coordinated, connected approach to optimize their care. To accomplish this goal, providers must be paid in a way that encourages a focus on prevention, care management, and care access, including telehealth.
The last year and half was a time unlike any in public health during the last century, with employees and their family members burdened with even greater medical and behavioral health care needs. To meet those needs and to have a healthy America, providers and employers must work together.
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