VH Insights

Behavioral Health 101
February 18, 2022

How Can You Coordinate Care for Behavioral Health?

Payers are leading significant reforms in healthcare, improving the quality of care for members with emotional, cognitive, or behavioral challenges. As the healthcare industry continues to transition to a focus on value-based care, many payer and provider organizations have recognized the influence that behavioral health has in driving their member’s overall health, and are using a blend of modern technology and whole-person care coordination to make a positive impact. 

What Is Behavioral Health?

Behavioral health by definition is a branch of care that addresses daily cognitive habits and their impact on mental health, physical health, and decision-making. Many behavioral health conditions are very common, such as anxiety disorders which affect 18.1% of Americans. According to Harvard Pilgrim Healthcare, common behavioral health conditions may include:

  • Major Depressive Disorder (MDD, or “Depression”)
  • Generalized Anxiety Disorder (GAD, or “Anxiety")
  • Substance Use Disorders (eg.: alcohol, tobacco, legal or illegal drugs, etc.)
  • Attention-deficit / hyperactivity Disorder (ADHD)
  • Autism Spectrum Disorder (ASD)

Individuals suffering from poor behavioral health exhibit a variety of symptoms from the less severe such as poor sleep and hygiene, to the more serious including, but not limited to:

  • Disordered eating
  • Substance abuse
  • Self-harm 

Symptoms of poor behavioral health can often mirror mental illness, but the terms are not interchangeable. Behavioral health care encompasses a wider range of conditions and behaviors, and its primary purpose is to take a more holistic approach to care and address root causes of common behavioral challenges rather than solely treat them. 

A High Demand

Issues related to behavioral health, particularly mental illness and substance abuse, have risen dramatically over the past several years. Suicide and drug overdose deaths are rapidly increasing, and the life expectancy of those with serious mental illnesses is significantly lower than the general population. Though the demand has risen for behavioral care, the current pool of providers specializing in behavioral health is insufficient to address the sheer volume of cases. In fact, less than half of Americans with behavioral health problems receive care. This shortfall is exacerbated by the fact that common behavioral health issues often are more prevalent among low-income, at-risk populations. Even more concerning, the care that is given is often not measured or tracked, leaving no method in which to measure the amount or quality of care administered. As more states take on healthcare transformation with a shift towards value-based care, especially among Medicaid populations, the industry is recognizing the direct impact that addressing behavioral health issues can have on improving member outcomes and controlling costs control. 

Payer Solutions

Some healthcare organizations are ahead of the curve in addressing behavioral health and have deployed technology solutions like HELIOS® to proactively coordinate care across the entire ecosystem of payers, providers, and third-party vendors. Solutions like these enable a whole-person care approach to member care that gives payers and providers a 360° view of each member of their population. This type of next-generation technology leverages both clinical and non-clinical factors to empower care teams in making the best possible informed decisions. When care teams can easily access urgent health matters just as easily as external variables, such as lifestyle, nutrition, and transportation access, they have the abiltiy to make positive, life-changing impacts, especially for those suffering from symptoms of poor behavioral health.

When leveraging a care coordination platform like HELIOS®, healthcare organizations can take more proactive roles in administering quality care for patients, thereby further ensuring better patient outcomes in this particularly vulnerable population. 

A Fundamental Shift

With behavioral health concerns reaching unprecedented levels, payers are in an advantageous position to make sweeping changes to the industry, address the problem, and make giant strides towards improving their respective population’s health. If health plans follow the growing trend of coordinated, pre-emptive, whole-person care, these vulnerable populations will have greater access to higher-quality care, at lower costs. It is imperative that payers seize this opportunity because when behavioral health is properly addressed, at-risk patients can often live longer, healthier, happier lives.