By Ashley Johnson, CSC-AD, MSW-C
Staying healthy isn’t just about taking care of your physical health. Mental health also plays an important role in our overall well-being.
Recent studies, including the 2021 National Survey on Drug Use and Health released earlier this year, reveal millions of Americans face mental health and subsequent substance use challenges. In addition, alcohol and drug use is one of the leading causes of preventable illness and premature death nationwide.
We must take steps to promote mental health, prevent substance misuse and provide treatment and support to foster recovery through a holistic, public health approach that ensures everyone can receive accessible, affordable and equitable behavioral healthcare.
Waiving Costs, Focusing on Care
Recovery from substance misuse involves personalized treatment in an appropriate care setting. From one-on-one counseling to intensive outpatient treatment to inpatient residential services, recovery support can be expensive, and the financial burden often deters people from seeking the care they need.
Removing that financial barrier is a crucial step to ensure people connect to appropriate and timely support, and healthcare payers can take a leading role in dismantling this barrier. Healthcare company CareFirst BlueCross BlueShield (CareFirst) has emerged as a trailblazer in this regard, implementing a cost-share waiver for members receiving services through Intensive Outpatient Treatment in the insurer’s Substance Use Disorder Program.
Providers offer treatment based on individual clinical circumstances in a community setting rather than a hospital or residential inpatient program. Patients are not required to be in a care plan to receive support and may be eligible for a waiver of many in-network costs, including copays, coinsurance and deductibles, to help alleviate the financial burden of their recovery and instead focus on getting better.
Accessing the Right Care
In addition to removing financial barriers, it is also essential that those seeking care can find it.
Finding and establishing a relationship with a healthcare provider can be a challenge. Are they in network? Are they accepting new patients? Do they specialize in the services I need? Is this provider someone I can trust, who will be empathetic and compassionate?
In recent years, Maryland has struggled to keep pace with the national average for physicians available for clinical practice. Beyond physicians, the healthcare workforce shortage in the U.S. means there are also fewer nurses, healthcare educators, home health aides and more.
While healthcare organizations are working to address the lack of adequate access to healthcare providers, CareFirst is tackling this issue on multiple fronts in terms of connecting members with behavioral healthcare and substance use disorder treatment.
Within its existing network, CareFirst has identified trusted providers partnering with the healthcare company to expand access to behavioral healthcare services. To ensure members are not lost in the shuffle of waitlists, these providers offer regular updates on patient rosters to ensure CareFirst Care Coordinators can schedule appointments on behalf of members seeking care.
This strategic move ensures that referrals are not blindly directed to unfamiliar facilities but to providers with whom the organization has established relationships, emphasizing the importance of a personalized and informed connection between providers and those seeking treatment.
The DocTour Will See You Now
On a much more fundamental level, primary care and behavioral health providers play a crucial role in helping their patients get and stay healthy. Understanding this link between primary care and substance use disorder treatment requires proactive steps on the part of everyone—providers, payers and patients.
CareFirst’s DocTour program aims to integrate behavioral health into primary care providers’ wellness checks. By educating these frontline providers on the significance of behavioral health and equipping them with the tools for proper assessments, CareFirst aims to bridge the gap in understanding and support.
The program’s emphasis on forging relationships between primary care providers, specialists, and behavioral health professionals is a crucial step toward a more integrated and interconnected healthcare system.
Addiction Does Not Discriminate
Like many healthcare conditions, addiction and substance misuse reach every county and neighborhood across the country. Maryland is no different, and my family is no exception.
I have helped loved ones navigate the challenges of addiction and I’ve been with them through the ups and downs of treatment. The path is rarely straightforward, and recovery is hard. It shouldn’t be made harder because people can’t find or afford the support they need.
Through a proactive, holistic approach, we can alleviate, if not eliminate, these barriers, transforming the landscape of behavioral healthcare and making a profound difference in the lives of all around us.
Ashley Johnson, CSC-AD, MSW-C, is the Behavioral Health Project Manager at CareFirst. In her role, she oversees the Substance Use Disorder, Cost-Share Waiver program and works closely with care managers and providers to ensure the people and communities throughout the Mid-Atlantic region have access to affordability and equitable behavioral healthcare. For more information about mental and behavioral health resources, visit carefirst.com/mentalhealth.