BY MARY LANGOWSKI
The healthcare sector is only beginning to grasp the toll that pressures during the pandemic are taking on Americans’ mental and physical health. Some 84% of respondents surveyed by the American Psychological Association in January 2021 reported symptoms of prolonged stress, while 67% of respondents said they felt overwhelmed by the number of issues America is facing. Even before the pandemic, more than half of adults (55%) in a Gallup poll reported feeling stressed “a lot of the day.”
The $1.9 trillion American Rescue Plan that President Biden signed into law in March earmarks approximately $4 billion for programs that support the prevention and treatment of substance abuse and mental health conditions. Vast amounts of investment dollars are also driving a new assortment of digital and community-based providers that can help individuals manage their stress, sleep, social isolation, tobacco cessation, weight gain and other common conditions.
However, despite new options for addressing our mental health needs, the system can be difficult for individuals to navigate to find the best provider for their needs. The number of point-solution providers (or those treating a single need rather than a range of conditions) makes it difficult for large payers to identify those offering truly evidence-based services. Vetting, contracting and managing those relationships requires substantial resources for payers. A payer could easily invest hundreds of hours to select focus areas and providers, audit those providers and integrate each one into its offerings — not to mention the staff hours required for monthly monitoring and performance reviews of each provider.
The health sector needs ways to streamline the process of finding and providing consumers with increased and easy access to relevant digital and community-based providers who meet their needs.
The health sector needs ways to streamline the process of finding and providing consumers with increased and easy access to relevant digital and community-based providers who meet their needs. Tailored solutions targeted to individual needs are beneficial to payers, providers, and most importantly, help address the specific mental health needs of a person and their family.
Platform solutions
Technology solutions are helping consumers find and access healthcare that fits their specific needs, while enabling payers to work with a curated roster of providers through a single vendor that functions as a gateway to multiple providers. These platforms can be integrated into a payer’s own provider selection infrastructure to create a seamless experience for the consumer.
Advanced digital health platforms can give the individual employee, plan member, or patient a single touchpoint for streamlined engagement and management of chronic conditions. Based on submitted profile info, a platform can match consumers with their best-fit digital and health-community-based solutions. Whether it be connecting users with companions to combat loneliness or providing digital and coached tools to positively impact low- to medium-acuity mental health needs, these customized plans allow members to craft their own experience.
The payer benefits by working with a digital platform of point-solution providers by increasing customer engagement with little additional administrative costs, since the platform can handle outreach on the payer’s behalf and can deploy best-in-class engagement techniques. With the ability to offer personalized health benefits plans that organize lifestyle, behavioral and chronic disease benefits for the member, employers and payers make it easier to choose solutions that address the user’s needs with less confusion. The platform operator can ensure the payer can offer the most in-demand treatments and services and can manage performance to ensure high-quality health care.
Other savings occur over the long term as treatment of stress, depression and other mental health issues helps to avoid costly medical care for conditions that could have deteriorated into more severe mental or physical conditions. By the same token, when consumers use the platform’s providers to stop smoking, lose excess weight, overcome substance abuse or make other changes that help them avoid chronic lllness and live healthier lives. Both plan members and payers benefit from the reduced need for expensive medical treatments down the road.
Treatment of some mental health issues, as well as prevention of chronic physical ailments such as diabetes and heart disease, often respond best to high-touch, low-cost programs that help individuals adhere to lifestyle changes for healthier living. Many digital and community-based providers deliver excellent results in the treatment of these and other conditions, which, if addressed early, may render more costly or invasive procedures unnecessary.
With the platforms available today, payers now have an efficient and effective means to tap various digital and point-solutions in the market. As mental health, stress, and substance abuse become larger issues that demand attention and more access to qualified providers and solutions, payers and employers can now offer their members tailored, digital resources to live healthier, fuller lives.
With the platforms available today, payers now have an efficient and effective means to tap various digital and point-solutions in the market. As mental health, stress, and substance abuse become larger issues that demand attention and more access to qualified providers and solutions, payers and employers can now offer their members tailored, digital resources to live healthier, fuller lives.
MARY LANGOWSKI is CEO of Solera Health. She is a nationally known healthcare executive with a successful track record leveraging market and public sector expertise to grow top-line revenue, drive new market opportunities and build successful organizations and new business models. Her previous roles include the founding and building of Rising Tide, LLC, a healthcare consultancy that she currently chairs, and EVP/Chief Strategy and Corporate Development Officer at CVS Health, where she led the foundational work of the Aetna acquisition. She has also held senior roles in both state and federal government.
In 2011, she was named one of Washingtonian Magazine’s 40 under 40 and “best in the business” by former Senate Majority Leader Tom Daschle. Mary serves on the boards for both Solera Health and Advantia Health.
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