posted by Alicia Caramenico
on May 19, 2016
The month of May is Mental Health Month, and AHIP is bringing attention to behavioral health benefits and mental health coverage in a new issue brief, “Ensuring Access to Quality Behavioral Health Care: Health Plan Examples.”
Roughly 38 million people had access to behavioral health care and benefits in 2014. Health plans know that for individuals with mental health and substance abuse disorders, it’s imperative they have access to evidence-based services to treat their underlying conditions; coordination with primary medical care; and assistance with basic needs such as housing, transportation, and job training.
The report includes case studies from 11 AHIP member health plans, which provide a detailed look at how the health insurance community is meeting patients’ behavioral health needs. As the report shows, each health plan approach shares certain fundamental features: education, outreach, timely access to care, quality measurement, evidence-based clinical criteria, and coordination.
Health plans use health risk assessments, claims information, and predictive modeling to identify individuals who may be at-risk for mental health issues and contact case managers and behavioral health providers to help treat their condition and prevent symptoms from getting worse.
When it comes to deciding what it covered, health plans and behavioral health care organizations use the same evidence-driven methodology and process across medical and behavioral benefits.
Find more information on some of the innovative programs health plans are implementing to ensure patients have access to appropriate, high-quality, evidence-based behavioral care in the full issue brief.