- Scott Pierce is Executive Vice President and Chief Operating Officer of BlueCross BlueShield, Tennessee.
A person’s emotional well-being and physical well-being are one and the same. With our society’s growing need for access to quality care, businesses have an opportunity to integrate mental health care into the broader health system.
As more people struggle with anxiety, depression, and stress, these symptoms are more relatable than ever. Fortunately, many people now feel more open and comfortable talking about their experiences. While we are grateful that this attitude toward mental health continues to decline, mental health statistics remain alarming.
Only 56% of psychiatrists accept commercial insurance, compared to 90% of other types of health care providers.
Meanwhile, nearly 1 million adults in Tennessee have a mental illness. By the way, that’s more than 1.3 times her in Nashville’s population and more than 5 times her in Knoxville’s population.
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Teladoc is one of a growing vehicle for expanding care
The underlying factor behind these statistics is the inability to receive the care they need. Simply put, there is a shortage of mental health providers. And most of them are concentrated in urban areas and often operate outside the health insurance system.
Blue Cross, like any insurance company, has an obligation to cover mental health treatment, and we accept this responsibility. We recognize that finding quality care can be difficult. All parts of the healthcare ecosystem need to work together to facilitate this. That’s why it’s important to be transparent about the challenges involved in expanding access and the steps we’re taking.
We understand that mental health providers feel underpaid, especially as many operate small clinics. They may not have the office infrastructure or resources to easily work with insurance companies to verify eligibility and submit claims.
We are working to improve our relationships with these providers to ensure that our members have access to the care they need.
This effort will begin by expanding our commercial network and significantly increasing remuneration for psychiatrists, psychologists and therapists. This he will start in the fall of 2023. We are also increasing access to digital care through programs like Teladoc, a telemedicine option that enables confidential mental health services from the comfort of our members’ homes. Our “Find Care” provider directory tool was recently updated to make it easier for people seeking behavioral health care.
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Get rewarded for increased access to care
We have modified our behavioral health case management program to focus on scheduling member appointments and working with healthcare providers to ensure appointment times and appropriate follow-up.
Case managers work more closely with the pharmacy team and use medication data to determine whether members fill new prescriptions for behavioral health medications. They can then engage with members as needed through multiple channels to ensure members are taking their medications as directed by their healthcare provider.
The first few weeks of this type of drug are very critical and our goal is to ensure that the first supplementation is successful. That’s a big step in itself.our most recent health equity report It helped identify which ethnic groups were less likely to receive certain treatments, and supported engagement efforts with these communities.
We also work with health care providers if members report side effects that may prevent them from taking their medications. Partnerships with these healthcare providers are extremely important. We all need to work together to scale behavioral health and ensure treatment success. That’s why we intend to work with providers to build a reimbursement system that rewards increased access, better quality metrics, and affordable outcomes.
We’ve also worked with customers in Tennessee who want to help their employees stay fit and healthy at work. Workplace burnout, anxiety and depression have all increased significantly. Employees are increasingly looking for employers who care about their mental health as well as their productivity. If we all stay involved, there will be less resistance to seeking care, and we will all be healthier as a result.
Scott Pierce is Executive Vice President and Chief Operating Officer of BlueCross BlueShield, Tennessee.