Behavioral Health Providers Must Continue to Refine Care Coordination Before Digital Takes Hold

The worldwide digital market for behavioral health care is booming, and is expected to grow to nearly $840 billion by 2027, according to Data Bridge Market Research. The current provider market is filled with a number of players, with an estimated 20,000 apps worldwide available through Apple and Android that support behavioral health.

Over $5 billion in investments poured into the telehealth space in the second quarter (Q2) of 2021, and year over year, global telehealth investment across all sectors increased 169% from Q2 2020. With market growth in telehealth, users now have more digital care options than ever, ranging from therapy to coaching to peer support services.

However, some in behavioral health feel that providers could do better in helping users navigate the wide array of resources. Among those who believe there is room for improvement is Doug Nemecek, the chief medical officer of Evernorth, a division of health insurer Cigna (NYSE: CI).

Nemecek and others shared their thoughts on the issue during the Behavioral Health and Well-Being Summit, a two-day virtual event hosted by the Validation Institute and the Association for Behavioral Health and Wellness shortly before the end of 2021.

“We see that at Cigna … that we can put [wellness platforms] Ginger or Meru Health or [eating disorder treatment app] Equip into our network,” Nemecek said during the webinar. “But when [patients] start to look for providers and see those names, … they don’t know which one is right for them.”

Telehealth claims for mental health conditions counted for 45% of all virtual health care claims in August 2021, far surpassing those for a number of medical conditions. While virtual and digital care delivery has been touted as a means of helping people receive more access to services, issues remain as to whether the assistance is effectively being coordinated to meet a myriad of needs.

Bernard DiCasimirro said he knows the issue firsthand as the senior vice president and chief medical officer of New Directions Behavioral Health, which partners with health plans, employers and higher education institutions to provide services to approximately 15 million individuals nationwide.

“Trying to find the bandwidth to connect patients to care on a consistent basis is certainly a challenge,” DiCasimirro said during the webinar. “More and more of our members are demanding access. They have evidence from friends [and] from family that this is something that is beneficial.”

Trying to navigate the many digital health offerings available — and guiding individuals to the best ones for their needs — can be dizzying even for one of the industry’s leading advocacy groups.

“What we hear from our members, from the people who call our helpline [and] people who are in our education classes is, ‘How do you even go about figuring out what might be best for you,” Jennifer Snow, the director of public policy for the National Association on Mental Illness, said during the webinar. “It’s a little bit overwhelming for our folks with mental health conditions.”

Working to make digital behavioral care coordination better

Nemecek believes that care coordination has long been a dilemma in behavioral health, but that the pandemic has especially brought it more into the light.

“One of the biggest issues that we faced in behavioral health for several years, obviously, is … people not knowing how to access support when they get into a crisis and … need to get some help,” he said. “A lot of our efforts — especially as the pandemic … ravaged the country over the last a couple of years — has been around how do we … improve the availability of support for individuals.”

When it comes to incorporating different services into benefit plans, Nemecek said that Evernorth is looking at offerings that employ three main areas of care delivery, which are physician-led, self-guided and digital resources. The various services provided by these routes take into account a variety of behavioral health conditions like stress and anxiety, as well as sleeping, eating and substance use disorders.

“Across those three areas, we’re looking at all of them to try to understand what’s the value that they bring, and how .. we incorporate that into a benefit plan so that individuals have access to what they’re looking for,” he said during the webinar.

For Laura Veroneau, who is a partner with the firm Optum Ventures, there is recognition within behavioral health that care coordination is crucial.

“I think the biggest evolution for us, and what we’re seeing, is behavioral [health] being not this one-size-fits-all thing, but a broad category that should have … specialization and personalization across multiple different areas,” Veroneau said during the webinar.

Optum has invested in a number of digital companies across the behavioral health spectrum such as Equip, Brightline, Alma and Groups Recover Together. Veroneau believes that digital resources from those and other companies can be useful in helping with behavioral health care coordination, particularly with telehealth access.

“Digital is a really interesting way, particularly for behavioral [health], to extend access points to places that otherwise might not have had access to treatment,” she added.

Vernoneau also believes more work is needed to improve digital behavioral care delivery. However, she is encouraged to see behavioral health providers bringing together peer support specialists, coaches and — in some cases — dietitians — together to provide a variety of care resources.

“There’s so much else that you can do around navigation around stitching these pieces together, … because you will never have your whole network tied into these assets,” she said. “I still think we’re in the phase of really innovating most heavily first on that carrier delivery aspect.”

For his part, Nemecek said those in the behavioral health space like Evernorth are up for meeting the challenge.

“What excites me is that we have the opportunity to leverage digital solutions … to really evolve … and figure out how to … optimally deliver the right supports at the right time to everybody,” he noted.