Honoring Mental Health Awareness Month: What Does the Future Look Like?
In 1949, Mental Health America led the way in establishing May as Mental Health Awareness Month. Since that time, mental health care has come a long way through a better understanding of behavioral health conditions, the development of corresponding evidence-based practices, and improved health care delivery.
However, we still have a ways to go.
Acknowledging May as Mental Health Awareness Month, Beacon Health Options wants to take time out to explore what good mental health and substance use disorder (SUD) care looks like as we strive to improve the lives of those people with mental health and SUD conditions. What are those factors that will “move the needle” from good care to excellent care? Beacon’s more than 30 years of experience has led us to the following four fundamental points:
- The most effective treatment incorporates physical, behavioral and social well-being. The concept of holistic care isn’t new, but the health care delivery system still hasn’t fully embraced it. To do so, we need to integrate care at the member, provider and payer levels.
- Community settings offer the optimal sites for care delivery. While inpatient or 24-hour care may be necessary at times to stabilize life-jeopardizing circumstances, this modality is best used sparingly. It is not as effective as sustained community-based care in changing health behaviors, establishing recovery, and supporting a well-lived life for those most affected by behavioral health conditions.
- Care should be evidence-based. Despite the presence of evidence-based treatments, primary care and some specialty providers have been slow to adopt these practices, particularly for SUD treatment. Due to barriers around provider training, member and provider education, and philosophical differences, many clinical treatments do not align with the evidence base.
- Pay for the quality of care, not the quantity of care. Value-based payment models, including risk-based and shared-savings models, bundled payments and more, provide incentive for providers to improve cost, quality and health outcomes.
Difficult but not impossible
On paper, the solution appears simple, but anyone in health care knows that execution is a lot more elusive. However, that doesn’t mean we should abandon our efforts to do so; there is evidence it can be done. Consider the following successful Beacon efforts that highlight holistic, community- and evidence-based care:
- Beacon co-developed a high-intensity care coordination program to support the most complex, at-risk members with SMI and co-morbid physical conditions for a client’s commercial and Medicaid beneficiaries. After analyzing clinical patterns, Beacon’s clinical team developed a plan-specific intervention program to provide holistic care by coordinating health services, address social needs, and guide provider and member health-related activities. The results? Individuals receiving the high-intensity care coordination experienced a 39% reduction in inpatient admissions and a 60% reduction in emergency department admissions.
- The Community Support Program for People Experiencing Chronic Homelessness (CSPECH), managed by Beacon’s Massachusetts Behavioral Health Partnership and the Massachusetts Housing and Shelter Alliance, provides community-based support services for chronically homeless individuals. The program pays for itself. One study revealed that savings more than offset the cost of CSPECH services, resulting in annual per-person net savings of up to $7,013. Put another way, every dollar spent on CSPECH translates into as much as $2.43 in savings due to reductions in other health care services.
- Starting in May 2017, Beacon partnered with a Massachusetts SUD outpatient provider to expand access to high-quality SUD treatment, which includes a bundled payment program that incorporates both financial risk and reward to incentivize quality care outcomes for members who opt-in to medication-assisted treatment (MAT). Initial outcomes indicate that the bundle is successful at driving member engagement and continuity in MAT, while preventing escalation to 24-hour substance use levels of care. For example, 95% of program-enrolled members maintain community tenure at 90 days post-discharge.
May as Mental Health Awareness Month affords us the opportunity to accelerate the discussion around mental health care. But that discussion can’t end on the 31st. It’s incumbent upon all industry stakeholders to follow the evidence, to find the creativity and the nerve, to execute where that evidence takes us.