Behavioral health in America is in a state of crisis. Individuals meeting the criteria for a mood disorder has never been higher at 40% of the US population. This prevalence is met with a pervasive stigma that holds many people back from seeking treatment. Those who do must overcome the challenge of access to quality care. As America’s first integrated behavioral care organization, NovaWell was created to breakdown the systemic barriers that prevent people from getting the care they need. Last week at HLTH, I had the opportunity to host 13 behavioral health leaders to discuss these challenges and potential solutions in greater detail. Takeaways from the discussion included:
Close the say-do gap: A misalignment exists between behavioral health as a strategic priority and the reality of implementing behavioral health solutions. Competing priorities, which demonstrate measurable short-term results, often gain favor and funding over holistic solutions where the value is recognized downstream via improved whole person outcomes and reduced total cost of care.
Breakdown siloes: Incorporating behavioral health into the fabric of an organization requires systemic change. The technology, processes and measurement of physical and behavioral health remain siloed. The first step to breaking down these barriers is internal. Organizations must undergo a cultural shift that emphasizes the benefits of whole person health, in order to fully realize the benefits.
Move beyond the network: Access remains a clear challenge for most organizations. Access was previously defined by the size of an insurer’s network. The larger the network the easier it was to access care. Our behavioral health crisis, pressurized by the healthcare staffing shortage and a movement towards direct-pay providers, requires the definition to change. Today, access is defined by how quickly a member can get the care they need. Solutions must be grounded in reaching people when they’re in the right headspace and quickly connecting them to care.
Redefine success: Behavioral health is currently measured against a framework that rewards the reduction of discrete behavioral health costs and perpetuates members cycling through the health system. Measurement should be framed around driving affordability long-term through upstream interventions – not short-term gains of reduced costs. If behavioral health is truly a strategic priority and improved outcomes is our North Star, it’s time we are measured against it.
Insist on sustainable financing: Currently there are too few billable codes attributed to those with behavioral health conditions. Existing CPT codes don’t provide enough insight into a person’s condition at traditional points of care - oftentimes leaving ED claims as the only source of data. Under this system, sustainable financing starts to unravel, resulting in limited career pathing for those in the field.
Advocate for policy changes: Regulation has the potential to make new inroads into the value of behavioral health. For example, students are required to get vision screenings prior to school, why not mental health screenings? With this type of data, school-based solutions could be funded that reach young people and teach them how to find care.
While the obstacles are great, I am heartened by the passionate, innovative leaders working to improve the lives of those with a behavioral health condition. The lively discussion demonstrated that behavioral health is a priority for many organizations, but delivering on that priority requires a shift in how we think and operate.