Health+Benefits the June 2022 issue

Bringing Behavioral Health into the Fold

Q&A with Jason Youngblood, Behavioral Strategy Director, Cigna, and Dr. Douglas Nemecek, Chief Medical Officer, Behavioral Health for Evernorth, Cigna Corporation’s health services business
Sponsored by Cigna Posted on May 31, 2022
How has the demand for behavioral health evolved since the onset of COVID? What are the top concerns you’re hearing from employer clients?

Nemecek: It’s important to recognize that even before COVID we knew that one in five adults every year had a diagnosable mental health condition. With the pandemic, we’ve seen a 25% increase in the number of people accessing behavioral health benefits for care and support. We’re hearing from employers that more and more people are looking for resources and help for emotional wellness and behavioral health in general.

As we work with employers, it really is about access and support. Upwards of 25% of us are dealing with behavioral health challenges at any given time. So, as we move past the acute phase of the pandemic and life becomes more normal again, it’s important to make sure that we don’t forget that all these behavioral health challenges haven’t gone away. We need to maintain this focus and momentum to continue to improve care and access and resources for people.

Have these new/increased requests for behavioral health resources changed the way you’re working with brokers and consultants?

Youngblood:Employers and the brokers that support them have a genuine interest in helping people get healthy and well, and the importance of behavioral health is now widely recognized. We understand now more commonly that treatment for people who have both medical and behavioral health conditions is three to six times more costly overall. And we have found that, when people with a diagnosed behavioral condition receive treatment, total healthcare costs decrease—up to around $3,100 per person over two years. So from my perspective, the way we view behavioral health has fundamentally changed. Everybody is awake to the needs of behavioral health, like no other time.

How are you addressing challenges to access and awareness?

Youngblood: I was recently working with a children’s hospital, and they shared a statistic with me: the need for child and adolescent psychiatrists across the United States is about 50,000; there are about 5,000 licensed providers. I’ve been a behavioral health clinician for over 20 years, and access to care has been an issue no matter where you live. Virtual care is one of the ways to address this. In 2020, we created the industry’s largest network of virtual healthcare providers. Prior to that time, just 2% of our customers had virtual behavioral health visits. Today it’s around 60%. We now have over 80,000 providers that offer virtual appointments.

What is the key to getting people more engaged in utilizing digital health services?

Nemecek:The availability of digital health services really helps expand the geography where we can utilize the limited resources and providers that exist. But what we found as we started to add digital resources and digital providers to our network is more is needed to help individuals understand how to engage in the ecosystem. So, in addition to access and awareness, navigation and helping people understand what these different programs and digital resources do is key. Helping them understand which providers can offer them true resources and support specific to their issue is an important need for us to help support.

What can the industry do differently to start treating specific populations?

Nemecek: Historically, we treated behavioral health more generally—we had one giant network and really the same recommendations for everybody. But as we start to learn more from quality, outcomes-based data, we can begin to identify who the best providers are for students, for women, for first responders, for veterans, for healthcare workers, for different racial demographics. It really comes back to, as an industry, how do we start to collect more data to understand what these different populations need and then how do we think about using data and identifying which resources from our network can more appropriately service these different groups.

One way we’re doing this: we recently announced our partnership with Behavioral Health Center of Excellence to create metrics that will allow us to differentiate autism providers for children based on their outcomes. By establishing consistent performance standards, we can build value-based care models and help our providers drive quality improvements.

What does the future of behavioral health look like?

Youngblood: There have never been so many ways to engage in your behavioral health and well-being, which is fortunate given the provider shortage in some areas. But the number one concern is how do you know what is the right thing for you. As I look at what’s in store for our immediate future, the key will be navigation. We need to meet people where they are, quickly evaluate their needs, and get them connected with the right resource. Access needs to be simple and easy. Today we are helping individuals who call or chat with us online get connected to the right provider or resource. And, we are building digital tools that will assess individuals, identify the right resources, and connect them to those resource digitally.

We’re at an exciting time, and whole-person health and understanding behavioral needs is part of that.

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