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Behavioral Telehealth’s Impact in Value Based Care Models 


A Humana provider and patient engaged in a telehealth appointment 


An analysis of data from the Medicare Current Beneficiary Survey found that “more than one-third of Medicare beneficiaries reported feeling less socially connected to friends and family since the start of the COVID-19 pandemic.” These feelings of disconnection and loneliness, partnered with the need to stay home and safe, resulted in telemedicine becoming a vital connective tissue between specialists and those seeking care for their mental health during the pandemic. However, as virtual clinical medicine as a whole tapered off months into the outbreak, behavioral telehealth visits remained relatively steady. Humana’s Medicare Advantage members affiliated with value-based physicians took part in nearly 628,000 behavioral visits, representing roughly 21 percent of all telemedicine visits in 2020. The usage rate per thousand among value-based members over non-value-based hovered between 5 percent and 10 percent each month between May and December.  Experts and practices incorporating behavioral telehealth attribute the consistent use to convenience for both patients and practitioners and the ability for those needing assistance to obtain help more privately.  


Steady utilization rates are important right now because many people are feeling the emotional effects of prolonged restrictions, lockdowns and grief. Offering a more private and convenient way to seek behavioral healthcare gives many access to this care who would forgo it in a normal setting.  “There are many barriers to getting to the front door and a stigma with behavioral health. Telehealth does away with that,” said Dr. Matt Ruble, Humana’s lead medical director for behavioral health. “This platform is critical in providing value, delivering greater value, and supporting the clinical model.”  



Primary care physicians in value-based arrangements recognize the impact of behavioral health issues on physical health and well-being, and many have begun incorporating behavioral specialists into their practices. That way, when a patient presents with potential psychological and emotional concerns, there can be an immediate, smooth handoff. “The setup lends itself perfectly to integration, especially in regard to timeliness,” Ruble said. TriHealth in Cincinnati began piloting integrated behavioral health in primary care practices in late 2016 and piggybacked on that infrastructure to expand services during the pandemic. Changes to state and federal regulations helped enable this change, allowing providers to bill for behavioral telehealth visits, including telephone visits, which was previously not allowed for psychologists and social workers. While changes to regulations may expire once the pandemic is over, Humana is committed to making these changes permanent. A TriHealth survey of its affiliated primary care physicians showed that the integration is making a difference for patients and providers. Some 97 percent of physicians expressed satisfaction with the behavioral health services, 95 percent said the integration somewhat or significantly improved their ability to manage patient needs, and 92 percent reported somewhat or significantly improved job satisfaction. Meanwhile, TriHealth patients surveyed at the end of each visit about its helpfulness rated them an average of more than 9 on a 10-point scale. 




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