Telehealth: The Savior of Behavioral Health Why Health Plans Should Care and How They Can Help

As the pandemic continues to simmer in the United States and rage on elsewhere, even with the bright spots of vaccinations and the slow return to “normal,” mental health issues are still increasing. The CDC recently reported that depression and anxiety increased 14% from August 2020 to February 2021. Even more alarming, there was a 27% increase in unmet mental health needs during that same time span. This is where telehealth comes in to save the day, fill those gaps in care, and provide an unmet need.

It’s no secret that COVID-19 rapidly facilitated the growth of telehealth use as it was embraced by providers, health plans and consumers alike during the early months of the pandemic. Recent data captured by Vizient in the study Effects of the COVID-19 Pandemic on Telehealth, reveals that consumers continue to be comfortable with receiving behavioral health interventions virtually despite restrictions being lifted. Telehealth visits across all specialties were at the highest in April 2020. The most telehealth visits delivered during this time was in neurology with 83% of visits conducted by telehealth followed closely by behavioral health and cardiology both at 79% of all visits. While it has fallen dramatically for all specialties by January 2021, for instance cardiology was reported at 17% and neurology at 40%, behavioral health visits conducted by telehealth remained high at 68%. This data makes sense as behavioral health lends itself well to telehealth visits over more physical types of health visits.

Behavioral Health Telehealth Benefits to Health Plans

Health plans are often met with low member satisfaction and continue to look for innovative ways to improve the member experience. There is no shortage of ways health plans are being measured on member satisfaction, access to care, and quality of care with measurements in place from HOS, HEDIS, NCQA and NPS scores. While there are many levers to pull, a report by J.D. Power illustrates that providing telehealth services to members leads to upwards of a 39-point increase in overall customer satisfaction.

We also know that members with depression are less satisfied with their health plan. For instance, in longitudinal studies that Engagys has conducted with health plan clients, we have found that after a depression diagnosis, member plan satisfaction can decrease up to a massive 400%. This could be especially important to Medicare Advantage (MA) plans as those members are more apt to research benefits and switch health plans if they are dissatisfied. According to a survey by eHealth, 79% of respondents reported that they review their MA benefits annually with 26% reporting they would most likely switch plans.

Mental health issues continue to increase as well as unmet needs for this group. When viewed through the lens of consumers embracing telehealth as a preferred option for behavioral health interventions and as well as increasing satisfaction with their plan, it only stands to reason that health plans should continue to offer telehealth as a covered benefit.

How Health Plans Can Help

Of course, the increase in telehealth usage is also driven by payment parity, and whether payment parity persists post pandemic will drive how this mix shifts in the future. Some states and plans are not waiting for CMS and are already signing parity into law/policy for certain specialties including behavioral health. For instance, according to Center for Connected Health Policy, all 50 states have some reimbursement for telehealth services with Massachusetts enacting the most comprehensive telehealth law to require reimbursement for both Medicaid and private payers. Plans that make telehealth reimbursement a standard operating procedure will be ahead of the curve.

Now let’s talk about Social Determinants of Health (SDoH). We know that from the joint Engagys RISE Fifth Annual Survey of Healthcare Consumer Engagement Practices, health plan leaders from over 100 healthcare entities are focused on addressing social needs factors such as transportation, food insecurity and access to care in 2021. Capturing members’ SDoH social needs and acting on them was second in priority only to multichannel communications. Also, in the same survey, health plans reported they had the biggest impact on improving behavioral health engagement when addressing social needs. This is great news as it turns out that when SDoH social needs programs are used, they improve clinical outcomes. For example, according to the Robert Wood Johnson Foundation, SDoH “can drive as much as 80 percent of health outcomes.” So how can health plans increase behavioral health interventions even more with SDoH social needs programs? By offering free or discounted broadband internet to those in low-income brackets. Reliable internet access can effectively solve the transportation and access issue this group faces since they won’t need to travel and can choose a mental health provider that is farther away but still in their network.

But health plan-run social needs programs are only as good as that health plan’s communications. Members won’t use services they don’t know they have, no matter how much it could help. And it’s not just the SDoH social needs programs members need to know about, they also need to know that telehealth services are covered. More than half of U.S. adults don’t know if telehealth services are covered by their insurance. Proactive communications targeted to members diagnosed and newly diagnosed with a mental health condition will go a long way in increasing utilization of telehealth and/or social needs benefits. Additionally, communications to the entire member base on telehealth services for mental health interventions could spur members to address undiagnosed mental health issues if they know there is a convenient and affordable mental healthcare option available.

Demand for telehealth services especially as it relates to behavioral health interventions will only continue to grow. Health plans that continue to cover telehealth services, provide better access to these services through social needs programs like free or discounted internet, and proactively communicate to their members about these benefits will effectively increase member satisfaction. Health plans can be a part of the solution by covering telehealth behavioral health interventions. They just need to make it affordable, make it easy and make it known.

Kathleen Ellmore

Ms. Ellmore is one of the earliest pioneers in bringing the best of consumer marketing and data driven methodologies to healthcare. Instead of getting you to eat when you are not hungry and buy things you don’t need, we can finally use the same strategies to instead change the health equation in America. Kathleen previously led the Consumer Engagement consulting practice for Welltok (formerly Silverlink) for 12 years, leveraging its data repository of over a billion consumer health interactions, the best of behavioral economics, and the latest in clinical research, to create evidenced-based communications on what works to drive consumer healthcare behavior yielding better outcomes and lower costs. She is often quoted in the trade and national press and is a regular speaker on the national stage, having spent the first twenty years of her career in brand marketing at leading consumer marketing organizations, including General Mills and P&G. Additionally, she was a Vice President at Digitas, a leading direct marketing firm. Recently she was selected as Consultant Member of the first ever FDA’s Patient Engagement Advisory Committee.