It’s clear that navigating the complexities of behavioral health care can be hard for both members and clinicians. The challenges — from finding the right specialist to ensuring that care is not only appropriate but also effective — are daunting. It’s been a crusade of the behavioral health industry to ensure the path to improved mental health is more direct, efficient and accessible.
To accomplish this, behavioral health offerings must be flexible and nimble enough to wrap around health plans’ existing resources and be inclusive to their members. Here are key core services that improve every aspect of behavioral health care delivery:
Network Enhancement
Health plans across the U.S. continue to face pervasive disparities in access to behavioral health care for their members. Health plans need technology to amplify their network by recruiting new providers, managing existing ones and ensuring that outcomes are measurable and effective. Beyond traditional network management, a tech solution can leverage data-driven insights to optimize provider performance and make sure members have access to high-quality, evidence-based care.
“By integrating these core tenets into your behavioral health ecosystem, you’ll not only enhance the member experience but also drive better outcomes, faster care and improved access.”
Leza Ogren, LICSW – VP, Clinical Operations
Utilization Management (UM)
It’s crucial that UM services focus on ensuring members have timely access to care that will meet their clinical presentation and provide expertise in evidence-based practices within the least restrictive environment. This guarantees that members receive the right care at the right time, reducing unnecessary treatments and improving overall care quality.
Care Management (CM)
For high quality care, care managers should focus on whole-person care by providing post-discharge follow-up, closing gaps related to social determinants of health (SDoH), medication management and care coordination services. The ability to support members long after their initial treatment will lead to decreased readmissions, the ability to build connections within their community and a healthier quality of life.
Autism Resource Program
Less than half of employer-provided self-funded plans with over 500 employees include coverage for Applied Behavior Analysis (ABA) services. With diagnoses continuing to increase, health plans must prioritize specialized support for families seeking autism care. For this type of complex care, clinicians must collaborate directly with family members, providers and health plans to create personalized care plans that meet the unique needs of the individual.
Substance Use Disorder (SUD)
Substance use disorders are linked to higher rates of hospitalization and health care costs, making them some of the most challenging conditions to treat. Health plans should seek clinicians that can assess risk and provide educational resources to help triage members to the appropriate providers, ensuring that each member receives the right level of care.
24/7 Crisis Support
Behavioral health crises can occur at any time and immediate access to care is crucial. The ability to support a member during a crisis can lead to less time in an urgent setting and potentially divert an acute admission completely. Around-the-clock crisis support and triage to emergency services, network providers and digital resources ensure that members have access to the help they need when they need it most.
In addition to our Navigate & Connect solution, Lucet offers these core services as the foundation of our approach to behavioral health care. By integrating these tenets into your behavioral health ecosystem, you’ll not only enhance the member experience but also drive better outcomes, faster care and improved access. If you want to learn more about how to simplify your behavioral health care delivery with Lucet, contact [email protected].
Leza Ogren is vice president of clinical operations at Lucet, The Behavioral Health Optimization Company.
