Medicaid Monday: Mental Health Innovations in Managed Care
In 2021, 34.2% of adults in Texas reported symptoms of anxiety and/or depression. Experiencing mental health challenges can have long-lasting consequences, especially for vulnerable populations. Every Texan deserves access to mental health services. Today’s Texas Medicaid managed care organizations provide a broad spectrum of screenings and treatment services for mental health conditions and substance use disorders with timely access for members and appropriate follow-up care. Managed care allows for flexibility in developing new models of service delivery that are not possible in traditional fee-for-service.
Combating Postpartum Depression
Cook Children’s Health Plan knows that the health care system can be fragmented and is working to fill in the gaps for new mothers. Approximately 10–15% of women develop postpartum depression. Postpartum depression is treatable but can have dire consequences if left undiagnosed. To capture the first signs of perinatal depression, Cook Children’s Health Plan screens pregnant women and new moms for depression using validated tools numerous times throughout the perinatal period. Cook Children’s provides behavioral health resources and referrals on the spot and contacts the Member’s OBGYN when signs and symptoms of depression are present. This reduces costly delays in services and improves pregnancy outcomes for Texas women.
Achieving Whole-Person Health
UnitedHealthcare Integrated Behavioral Health Homes are value-based arrangements with Community Mental Health Centers to develop and deploy an integrated care delivery model to an attributed population that addresses complex needs for members with serious mental illness, serious emotional disturbance, and/or substance use disorder. It is a total cost of care model with several quality measures. The program supports extensive data sharing and dedicated provider engagement staff. It aims to improve provider NPS as well.
Supporting Pregnant Women
The COVID-19 pandemic was a once-in-a-century public health crisis. Parkland Community Health Plan stepped up and listened to the unique needs of their communities during this time. The health plan was recently recognized for innovation for offering access to Pyx Health, a service primarily accessed via an app, to pregnant members across urban Dallas County and surrounding rural counties. Through a chatbot, the app connected members with individuals (both human and automaton) who promptly listened without judgment, helped identify resources, provided guidance to appropriate care, and connected members with various Parkland Community Health Plan benefits. The app used assessments of mental and physical well-being and social determinants of health to inform compassionate, respectful interactions. If indicated, prompted an outbound call from the staff to assist with urgent needs. It also compiled these results with user engagement data and provided reports to the health plan.