Executives from Optum, Cigna, Octave Health, and PsychHub weigh in

The first breakout session of the Future of Mental and Behavioral event on June 9th focused on innovative models of care in mental health.

Innovative Mental Health Care Models Despite the great demand, most people still do not have mental health insurance coverage. How do insurance companies and startups work together to give people the help they need? Moderators: Dr. Archana Dubey (Global Medical Director, HP), Bambi Francisco Roizen (Founder and CEO, Vator) Spokesperson: Kate Knutson (CEO at Optum Behavioral Care), Eva Borden (President, Behavioral Health at Cigna’s Evernorth), Sandeep Acharya (CEO & Co-Founder , Octave), Marjorie Morrison (CEO, PsychHub).

Here are some takeaways:

How do you attract therapists and mental health providers? Octave Health negotiates tariffs with insurance companies to offer therapists competitive tariffs and handles administrative paperwork. Cigna wants to make it easier for the provider to find the right patient. Matching requires several components for this. First, there needs to be a diversity of providers (gender, ethnicity, etc.) to cater to patients; Second, measurement-based instruments are required to assess the quality of care so that service providers can work at the highest level. Optum aims to optimize telemedicine and technology as well as a diverse workforce to expand the care team to meet the need with the right resources.

The service fee model for paying providers has to change. Optum’s Kate believes the fee-for-service model is failing when it comes to mental and behavioral health. Good mental health requires a team and collaboration between trainers, schools, families and providers. We have to get to population-based payments [a form of value-based care payment model] and measurement-based care to produce differentiated outcomes that can then lead to differentiated payments. Right now, in a world of service charges, when providers call patients between sessions for updates, those “micro-touches” are not funded. When a provider visits a patient’s school to advocate for the child, that micro-touch is not funded. The models need to be built to account for these micro-contacts. Payers need to update their claims systems and the industry as a whole needs to better correlate results with payments.

How is care measured? Sandeep found that only two out of ten providers provide measurement-based care; They are just not trained to follow care this way. Kate at Optum said the most robust measures to be taken are symptom checklists like the standard PHQ-9 and GAD-7; These are useful but difficult to collect; It is difficult for patients to complete these routinely; collect them in aggregated form and send them to the payer; Most providers don’t have EHRs to collect these surveys; We need to move beyond surveys to more objective-based measurements that track sleep, anxiety, and mood trackers. Cignas Eva says for poor visual acuity and subclinical patients who use behavioral medical instruments [e.g. Happify Health]Pharma claims that, considering the entirety of a person’s health experiences through medical, understand whether preventive behavioral treatments have an effect.

Therapists need to be more specific: Marjorie sees therapists move from generalists and more to specialists because treating insomnia is different from treating substance abuse; Precision matching can work when therapists / providers fine-tune their treatment protocols. Eva von Cigna agrees: In order for therapists to be paid for their services, the patient’s services and total expenses, such as pharmaceutical and medical expenses, must be more accurate.

The future of mental and behavioral health is brought to you by Vator and UCSF Health Hub. Thanks to our sponsors: Advsr, scrubbed, Stratpunkt. Go next to BetterHelp BetterHelp.com/Vator for a 10% discount on BetterHelp. This podcast is also provided by Octave, your mental health and emotional wellbeing partner. Learn more at FindOctave.com. Thanks also to NeuroFlow who works with hundreds of health organizations to provide world-class technology and services for the effective integration of behavioral health. Learn more at neuroflow.com). You can still register for our events on June 9th and July 14th, which are part of the Future of Mental and Behavioral Health series.


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