According to the Kim Foundation, one out of four Americans experiences behavioral health issues. Of those, 60 percent are not receiving treatment.
Why are so many people not receiving treatment?
What does this mean for providers?
What more can be done to increase access to behavioral healthcare?
Learn more about this issue by downloading Magellan’s new infographic, “Mind the Gap: Increasing Access to Behavioral Healthcare.”
You’re buying a car. Before you hit the lot, you do your planning and research, establish a budget, figure out what features you want and what style you’re looking for. You probably search online for car and dealer reviews, prices and sales. Based on all of that work, you make a decision, negotiate and pay for your new car.
Your car research was relatively easy. But finding a healthcare provider? Not so much.
While you may know what you want in a provider, very little information is available about the services they provide, appointment costs, reviews and other important details to help you make an informed choice about your care. And if you ARE lucky enough to find someone who seems to fit your needs, you’re often still left wondering what kind of quality you can expect from your treatment experience.
The bottom line is that it’s easier to buy a car than it is to find a healthcare provider. Silly, right? We think so, too – which is why Magellan is bridging these information and quality gaps by employing value-based purchasing models.
Rewarding quality care yields informed choices
Value-based purchasing takes various forms. But it generally operates on the premise that aligning providers’ incentives and reimbursement with organizational and individual goals incents behavior and drives positive outcomes, ultimately benefiting all involved in the healthcare continuum. This includes consumers, customers and payers, in addition to the providers themselves, who also enjoy improved reputations through public reporting.
In fact, one of the key tenets of Magellan’s value-based collaboration and purchasing models is to ensure stakeholders become more informed as a result of these initiatives:
Magellan’s models also center on:
Why do we give value-based purchasing strategies the green light?
Take our Assertive Community Treatment (ACT) program as just one example. Through program data analysis and close collaboration with our ACT provider teams, we developed a three-tiered rate structure based on overall program goals to support recovery, wellness, and to improve community tenure. As a result, we saw a 21 percent decrease in inpatient admissions and a 24 percent decrease in the inpatient readmission rate.
Our drive for engagement continues
Providers nationwide are in different phases of readiness, so we keep our wheels in motion by providing a graduated maturity model to move them from the most basic stage—learning the behavior through activity incentives—to the most complex arrangements, which transform care delivery through outcomes-based incentives or other payment structures (2). We look forward to working with stakeholders, providers and consumers as we continue to expand this innovative and exciting model.
(1) Medical Strategy Group Council: “Next-Generation Physician Composition,” The Advisory Board Company
(2) Physician Quality Reporting Initiative: The Advisory Board Company
Consumerization of products continues to drive new innovations across the marketplace. For example, you can use your smartphone as a GPS device, to request a car service directly to your house and to shop for a new car online, seeing the prices other people paid in real time. In banking, we’ve seen the transition from teller to the ATM to online banking, smartphone banking and now, using your smartphone as a smart pay device. Underscoring all of these innovations is the desire to make whatever experience the consumer is engaging in easier, simpler and more personalized.
Healthcare is no different. Across the healthcare continuum, companies like ours are finding new and innovative ways to enhance member engagement and participation in the healthcare journey, particularly through computerized or mobile devices. Think about how healthcare has changed over the past 50 years – house calls from doctors to office visits to telephone triage and now, computerized therapy and text therapy.
At Magellan, we’ve invested in a unique type of computerized therapy – Computerized Cognitive Behavioral Therapy (CCBT) – to help individuals seek the therapy they need, in the comfort, convenience and privacy of their own home. Our CCBT programs were originally developed more than 20 years ago, for stand-alone personal computer use, but have since been developed for use on the internet and mobile devices, in both English and Spanish.
The following five conditions make up more than 90 percent of behavioral health complaints in adults, and are present in more than 25 percent of adults:
Within each condition, studies have shown CCBT to be effective at reducing symptoms and severity. Importantly, our CCBT programs have undergone clinical trials involving more than 1,000 patients and have received endorsements and recognition from the American Academy of Sleep Medicine, the United Kingdom’s National Institute of Clinical Excellence, Accreditation Canada and the Substance Abuse and Mental Health Administration’s National Registry. Underscoring all of the studies and reviews, what can members expect? Sixty-nine percent of users show meaningful improvement within 30 days.
But CCBT isn’t just for members. We’ve found that providers can use a tool called Smart Screening to help screen individuals and triage them to the most appropriate levels of care on the CCBT platform, and in person, for the most serious cases. Various levels of screening can help direct individuals to CCBT, directly to an in-person counselor or a mix of both. Through this triage system, 90 percent of engaged participants rate this program as helpful and useful, and 75 percent of individuals actually prefer a non-medication care option when asked.
The most important thing about innovation in any industry – healthcare, banking or electronics – is refusing to rest on your laurels. There are new start-ups launched everyday whose mission it is to disrupt the status quo and provide new ways of doing things. As healthcare evolves, we plan to do the same.
Written by Thomas Lane, NCPS, CRPS
What’s in a word? Much more than many of us realize.
In the context of behavioral health, substance use and even physical health challenges, using terms and phrases that group people by diagnosis, disability, disease and other characteristics perpetuates stigma, discrimination and exclusion. Yet this type of language has been part of the healthcare lexicon for decades. Outdated terms such as “addict,” “crazy” or “diabetic” are just a few common examples.
We live in a time when individuals are at the center of the healthcare field. As healthcare consumers, individuals are empowered to make their own health choices. As healthcare professionals and activists, we need to mirror this empowerment, and seize the opportunity to pivot how we portray what we do. We need to move away from archaic language that contradicts all of the positive changes we help individuals make in their lives on a daily basis.
This is where “person-first language” can make a big difference.
What is person-first language?
Person-first language means seeing people as “people first,” and not as their disease, illness or disability, or as part of a homogeneous group. It portrays individuals living with behavioral health, substance use or physical health challenges beyond a lens of illness, diagnosis and hopelessness. It helps address issues relating to illness-identity and self-stigma, keeping in mind that we are all unique individuals, with unique lived experiences.
At Magellan Health, our use of person-first language stems from our work in behavioral health, but it applies to everything we do with equal emphasis. It shows our commitment to being culturally and linguistically appropriate in all of our communications. It models our principles of recovery and resiliency, and contributes to evolving and improving our organizational culture.
On a personal level, as an individual in recovery myself I can tell you how important person-first language became to me as I discovered the often unintended consequences of using language that robs one of their individuality. We all deserve respect and appreciation for our unique qualities.
How is person-first language used?
Using person-first language is an intentional practice. Here are some examples of old language that is commonly used in comparison to newer, person-centered language that can be applied by anyone:
For practice, try to recognize when others use the outdated or inappropriate terms and phrases above. And ask yourself how often you use them. Then, make the conscious choice to omit them from your vocabulary and replace them with new terms. While changing an old habit can be a challenge, consciously developing a new one is an easier path to meaningful change.
Remember, we all have choices about the words we speak and write. Those choices can either affirm the distinctive individuals that we are — or diminish us with labels. The words we use can fill us with hope, or burden us with despair. So let’s choose hope.
Changing the way you speak and write is a gradual process. But by putting the person first when you do, you can play a role in bringing our healthcare language into the 21st century.
For more information and resources, please visit Magellan’s e-Learning Center: http://www.magellanhealth.com/training-site/home.aspx