AbleTo, Big Health Execs: Policy, Care Innovation Is Critical to Behavioral Health Equity

The U.S. still has a long road ahead of it before reaching behavioral health equity.

However, public and private entities are looking to change this paradigm through innovative legislation and technological advances. These innovations focus on expanding access to care and further integrating behavioral health into the health care continuum.

“You cannot achieve equity if you’re not addressing the underlying issues that frame our society, and that includes behavioral health access,” Dr. Meena Seshamani, director of the Center for Medicare at the U.S. Centers for Medicare & Medicaid Services (CMS), said during a panel at The Future of Mental Healthcare East 2022 conference.

Behavioral health is part of overall health and can impact physical health outcomes, according to Seshamani and other panelists. Research shows that individuals with serious mental illness have reduced life expectancy and poorer health outcomes than the general population.

Panelists stressed the importance of integrating mental health into the continuum of health care.

“If you’re not caring for someone holistically, they end up in the hospital getting very sick,” Seshamani said. “How can you spend money in a smarter way so that you’re keeping people healthy and keeping communities healthy? And so I think behavioral health again, really, is key to all of our pillars across CMS.”

Legislation’s role in behavioral health equity

CMS is now looking to tackle health disparity through new legislative measures, including its Physician Fee Schedule.

“We have a very aggressive behavioral health agenda; No. 1, to mobilize the behavioral health workforce,” Seshamani said.

CMS recently proposed a new Physician Fee Schedule for 2023, which encourages clinicians to practice at the top of their license. It shifts physician supervision requirements from direct to general for marriage and family therapists, licensed professional counselors, addiction counselors and certified peer recovery specialists.

The ruling also proposes paying psychologists and social workers to help manage patient health in primary care teams. Additionally, it pitches mobile units to help provide opioid treatment and recovery services.

The digital divide

Legislation isn’t the only way to combat behavioral health disparity.

Celeste James, vice president of equity and population health at Big Health, said that new technologies, such as digital therapeutics, can also help move the dial on behavioral health parity.

San Francisco, CA-based Big Health is a digital therapeutics company. Its products include insomnia digital therapeutic Sleepio and anxiety Daylight for anxiety.

Digital therapeutics are evidence-based treatments delivered through software interventions to treat or manage a condition. These therapeutics can treat everything from opioid use disorder and depression to ADHD and insomnia.

“When we think about access to mental health care, we talk about the stigma,,” James said during the panel. “Digital therapeutics tend to reduce stigma, because they don’t judge, they don’t discriminate.”

Digital therapeutics also can be designed in a way that’s culturally responsive, James added.

“They’re convenient; you can do it in your car, your office, wherever,” she said. “It’s really an easier way to get the kind of care that people need in the way that they want it. And that’s innovation, and that’s what’s going to get a more equitable way of providing care for mental health.”

While new modalities of care continue to evolve, panelists warned that it’s important to innovate for all patients – not just the ones who can pay for it.

“There’s so much innovation happening in health care, which is awesome, but it’s not reaching everyone,” Reena Pande, chief medical officer of AbleTo, said during the panel.

With that in mind, innovators need to think about ways to ensure their “great work” around high-quality, outcomes-driven care actually reaches those who need it most, regardless of their ability to pay for it.

New York-based AbleTo is a virtual behavioral health company. In 2020 the company was acquired by Optum for $470 million.

“Everybody, whether you’re a Medicare member, or a commercial member; you’re uninsured or whatever,” Pande said. “It [must] be that we can get innovation in the hands of those who need it.”