Across our country, across Texas and especially in the San Antonio area, many people with behavioral health issues aren’t getting the help they need. Too many people wait six months or more just to get an appointment.
This needs to change. Humana is teaming with the Center for Health Care Services, or CHCS, to focus on this critical issue together.
According to the American Psychiatric Association, about 34 percent of the U.S. population has a mental illness, including substance-use disorders. Humana research shows that up to 80 percent of behavioral issues present as physical health problems, including headaches, sleep issues and high blood pressure, and the overall cost of care for people with both mental health conditions and associated medical conditions is two to three times higher than for people without such comorbidities.The American Psychiatric Association reports that only 40 percent of adults and 50 percent of children with a diagnosed mental illness receive treatment.Many mental health professionals don’t have the capacity to take on new patients. Increasingly, the number of new mental health professionals is inadequate to keep up with the demand, and as many as half of psychiatrists don’t accept insurance. Some don’t take patients with Medicare coverage.
Humana asked mental health professionals about factors limiting their participation in networks. Among the reasons:
Little incentive to join a network … practice already full.
Dealing with insurance takes time away from patient care.
No staff to help with paperwork.
Pay rates for mental health services are not adequate.
Those are among the top reasons we now are partnering with the Center for Health Care Services here in San Antonio.
We see opportunities for improvement. CHCS serves people with insurance, people without coverage, people with Medicare and Medicaid — basically, anyone who needs behavioral health care.
We have hired a Humana behavioral health clinician and are coordinating care with CHCS and our Medicare and commercial network. We’re considering placing CHCS clinicians in some Humana-affiliated medical clinics, moving the system toward an integrated approach to treating behavioral health. And a telepsychiatry pilot is underway at five Humana-affiliated health care clinics.
To address the concerns mental health professionals have about participating in insurance networks, Humana is taking these steps:
Expanded access: We’re working to recruit more behavioral health providers to our networks, expand telepsychiatry, and pursue other strategies to secure more timely access to needed care.
Network modifications: We’re establishing networks designed to require less administrative work and dedicating additional Humana associates to manage relationships with our mental health care providers. Also, we’re ensuring that psychiatrists who are listed in our networks actually are available for appointments with our members.
Integrated behavioral health care: We’re training and incentivizing primary care physicians to integrate behavioral health care into their practices and noting in our directories which primary care practices offer mental health services.
Better collaboration: We’re working with primary care physicians, behavioral health practitioners, addiction professionals, community health centers, large health care systems and university medical centers to incorporate collaborative care models that recognize and treat both mental and physical health needs of patients.
Reimbursement changes: We’re increasing payment rates in high-demand specialties and geographies, analyzing community data to ensure mental health professionals are compensated fairly.
Through innovative partnerships, we are confident we will quickly make progress to ensure more people get the care they need when they need it.