Mental Health: Managing the complex needs of the dual-eligible population
When Belong Health opened its doors in 2021, our mission was clear, urgent, and deeply felt: to reshape the future of healthcare for those most underserved by the status quo. That mission hasn’t changed. If anything, it’s only been emboldened by our early successes and by enthusiastic partnerships.
Through each of those relationships, we’ve gained an deepening knowledge of the thorniest complications of the healthcare system — from staff burnout to scarcity of resources to a communication gulf widened by differences in geography, education, and cultural background.
Among these many challenges, the topic of mental health, one that influences and complicates every age and sector of American life, seems to bubble to the surface with stunning regularity. In keeping with our commitment to whole-person care, we believe addressing the mental health challenges of the members we serve will lead to noticeable improvements in nearly every aspect of their lives.
Recognizing a Challenge
In early 2020, the onset of the COVID-19 pandemic changed the world forever. Businesses were shuttered, futures were reimagined, and millions of lives were lost. Across America, those rippling impacts are still felt today, including a 25% increase in mental illness since the pandemic’s beginning.
In the face of this new reality, our nation’s healthcare system struggles to respond. Today, in New York state alone, the average wait time for an appointment with a mental health provider remains at around six months, according to the Journal of the American Medical Association (JAMA).
This troubling gulf between mental health demand and the supply of mental health clinicians is especially costly for members of the Dual Special Needs Plan (D-SNP) population, whose rates of mental illness (64%) are significantly higher than those of Medicare beneficiaries who are not also on Medicaid (40%). Compared to those without mental illness, members with comorbidities and mental illness carry two times the medical expenses, even as they aren’t extended two times the response in medical aid.
Instead, such members frequently find themselves in a healthcare purgatory, adrift and without prompt follow-up after emergency room visits or inpatient hospital stays. Between 2019 and 2022, according to a study from Trilliant Health, half of patients who were treated in an emergency department for anxiety or depression did not receive care from a behavioral health provider within 60 days after that visit.
That figure rose to 83.5 percent for patients treated in an emergency room for alcohol or substance use disorders (SUD). In fact, care network gaps for mental health and SUD regularly worsen for members of Medicare and Medicaid members, as the less-favorable reimbursement rates offered by these programs motivate fewer psychotherapists, psychiatrists, and other mental health specialists to accept them.
With the expertise of our personalized care management teams, Belong Health works diligently to help fill those gaps where D-SNP patients are most in need. During health risk assessments — or during transitions of care, as beneficiaries move from an inpatient hospital stay into their post-discharge period – we provide holistic support that reliably links each patient to exactly the care they need at exactly the time they need it.