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For the past 15 years, I’ve seen healthcare professionals discuss how to solve the growing behavioral health crisis. While many have advocated for better quality care to free up access, the prevailing solution has been hiring more behavioral health providers. Increasing access is important, but it was also the go-to and often only solution many health plans pursued during the COVID-19 pandemic, whether that was investing in digital solutions to enable self-care and teletherapy or expanding their behavioral health provider network. Today, we’re reaching a pivotal moment: With all the access health plans have invested in, what’s actually working? Is the access connecting individuals to quality care? How can healthcare leaders create standardized mechanisms to measure behavioral health and answer these questions?
Behavioral health care faces two glaring problems, which contribute to systemic barriers to access and quality care: it remains incredibly siloed from physical health, and as a result, it has not been held to the same standard of data collection and measurement-based care. Unsurprisingly, health plans don’t have the necessary insights to understand who needs behavioral health support and whether the programs and benefits they provide are making a positive impact.
And it’s mission critical that the healthcare industry tackles this data problem because healthcare costs continue to rise. In fact, a recent survey from Business Group on Health predicts costs will reach a 15-year high in 2025. A significant contributor to those costs is untreated behavioral health conditions.
Given rising costs, risk-bearing healthcare organizations (and the employers that pay for their services) want to understand, “How are the programs I’m paying for making a positive impact on my population’s health?” Without behavioral health data, many organizations won’t be able to answer this question. And staffing alone won’t solve the problem. The question health plans must answer is: How can we collect the right population insights to understand risk and whether that risk is being appropriately managed? Healthcare will always face constraints; there simply aren’t unlimited resources to meet demand for services. Having better insight into behavioral health can help plans use those limited resources more effectively and make better decisions. This will unlock greater efficiency, setting up health plans to tackle the access problem and check out-of-control costs.
To right these systemic wrongs, health plans must incentivize universal behavioral health screening across care settings – behavioral and physical. Screening of behavioral health needs population-wide allows organizations to understand who needs support, and it takes the onus off patients to ask for help. Relying on a patient to navigate a complex healthcare system and find the right program allows too many individuals to fall through the cracks. Their symptoms remain untreated until they escalate to a high-cost care setting, like the emergency department.
Critically, patients must receive screenings regularly. Annual depression screenings capture symptoms one day out of the year for a condition that can change significantly across those other 364 days. And these screenings need to actually go somewhere – not on a paper filed away, but integrated into healthcare infrastructure so that providers and payors can act on this behavioral health data appropriately.
Previously, it wasn’t possible to achieve these aims at scale, but technology is empowering healthcare organizations to deliver screenings regularly, remotely, and digitally so that providers or care managers can track individuals’ wellbeing over time and understand how to best support them. Integrating this data into existing care platforms unlocks insights that can help providers intervene early when a patient is showing signs of decline. Instead of utilizing high-cost care, that person can be enrolled in an appropriate program and get the help they need.
Once health plans establish rich data collection, both in physical and behavioral health care, they can begin to invest their resources more effectively to drive the greatest impact. This is particularly critical for health plans who historically haven’t had insight into behavioral health care and its impact on their members. Considering that individuals with behavioral health conditions drive 6X higher medical costs than those who don’t have these conditions, it’s incredibly important that health plans understand which programs are making a meaningful difference on outcomes and lowering costs as a result.
Measurement-based care, delivered at scale, can finally shed light on behavioral health program performance, and arm health plans with the tools they need to appropriately incentivize their provider networks. We’ve seen the transformative power of a tech-driven, measurement-based care approach firsthand with our partner Colorado Access.
Colorado Access is a non-profit health plan serving primarily Medicaid members. It has a robust network of behavioral health providers, but wanted to understand how effective these programs were in driving positive clinical outcomes and ultimately lowering care costs. The health plan provided NeuroFlow’s measurement-based care solution Owl to its behavioral health providers. The solution makes it easy to regularly measure patient symptoms and track progress over time both within and outside of the clinic. If patients' symptoms don’t improve, providers can adjust the treatment plan, or if patients scores indicate remission, they can receive stepped-down care.
Having this data allowed Colorado Access to see that the behavioral health programs that utilized measurement-based care reduced patient symptoms. These providers drove 56% faster time to remission for their patients compared to those who did not engage in measurement-based care. That led to a 30% increase in access because these patients were eligible for discharge or stepped-down care.
As a result of helping patients recover more effectively and efficiently, Colorado Access saw a 63% reduction in ED visits and a 75% reduction in psychiatric admissions. That decrease in utilization translated into a 28% reduction in PMPM costs. With these insights, Colorado Access can more effectively incentivize its provider network to utilize this technology and deliver high-quality and cost-effective care.
We’re entering a new phase of healthcare. After adding significant behavioral health access in the wake of the pandemic, it’s time for health plans to implement standardized ways to measure these programs’ success. Employers are demanding this level of insight. According to that same Business Group on Health survey, one third of employers are planning to renegotiate their contracts in 2025, given rising healthcare costs. Employers said that when they evaluate health plan partnerships, both claims data and data measurement and transparency are top priorities.
We can’t solve for what we can’t see, which is why now is the time to invest in actionable behavioral health data, whether that is in the therapist’s office or in ambulatory care. By incentivizing measurement-based care across their networks, health plans can provide the transparency employers are looking for and leverage these insights to invest their resources more effectively. That will significantly lower costs, which Colorado Access has demonstrated and continues to demonstrate today.
Health plans who fail to adapt to this new phase of behavioral health care risk falling behind their peers and lacking the critical tools they need to justify their programs and make better decisions. Access is important, but access without data and evidence of impact is simply added costs, which the market is no longer willing to bear.
Robert Capobianco has extensive strategic and operational experience with tech startups and large corporate organizations. He has a proven history of developing innovative strategies that drive revenue growth and market leadership resulting in multiple exits through strategic acquisitions - collectively exceeding $200M in acquisition value. Robert has over 25 years of experience in the healthcare technology industry, helping health plans access and activate robust population analytics to build more comprehensive alternative payment solutions that reduce costs and improve outcomes. In his current role, Robert is the Chief Commercial Officer at NeuroFlow. He is responsible for defining and executing NeuroFlow’s long term commercialization and business development strategy.
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