With more than 1,000 locations across the U.S., CVS MinuteClinics have gained in popularity among patients for treating non-emergent physical health conditions. MinuteClinics are now doubling down on their behavioral health efforts, too.
CVS Health (NYSE: CVS) announced that six Los Angeles-based MinuteClinics would staff licensed mental health professionals. This entrance into the California market marked the 14th state MinuteClinic has made such a move.
Behavioral Health Business sat down with Ashley Karpinski, executive director of behavioral health plus enterprise collaboration and care delivery at CVS Health, to talk about what’s next for MinuteClinic’s behavioral health efforts.
This conversation has been edited for length and clarity.
BHB: When did CVS MinuteClinics begin staffing licensed mental health providers, and what was the thinking behind that?
Karpinski: This predates the pandemic. We’re really focused on how we bring mental health across our assets, including CVS MinuteClinics. So our MinuteClinic mental health counseling services became available in January of 2021, primarily in Houston, Philadelphia and Tampa. We started in some key markets, then we grew from there.
We wanted to learn more about the impact we can have on improving access to care. We also wanted to start educating communities that to have solid health care, you need mental health care. It’s part of health and not just a separate thing we do.
Traditional mental health care is complicated. Folks don’t know what’s in-network and out-of-network. Do I need a licensed therapist? Or do I need a psychiatrist? If I’m feeling depressed, do I need medication? We felt like we could play a solid role in communities by addressing some of those challenges.
We hired licensed mental health providers, and we have multiple disciplines. We provide virtual and in-person care. We know that one of the great things about the pandemic is that adoption of virtual care has become more mainstream. Whereas before, it was something you could do, but not the primary mode of care. We’ve really seen people take advantage of that.
How many locations have licensed mental health clinicians?
We’re in 14 states. And within those states, of course, our brick-and-mortar presence is in very key markets. So, for example, we cover Texas, but our in-person availability is in the Houston market. And in Florida, we cover all of Florida virtually, but we’re in Tampa.
What we find is that the majority of folks are using virtual care. So although many like the access in-person, we are seeing great adoption from all over the states where we’re providing care.
CVS recently announced six new locations in the L.A. area were staffing mental health clinicians. Why did CVS choose this market?
When we go into a state, we really try to understand the demand and the need, and select key locations. That varies, and you’ll see us growing into other markets.
Because L.A. is one of the largest metropolitan markets, where we have a high concentration of MinuteClinics, it made sense that we try to create a care ecosystem there. Imagine – you can get your mental health care, your physical health care, potentially prescribed medications in one place. It starts to create this holistic environment.
What are some of the lessons learned from these centers?
The care we originally talked about focusing on was mild to moderate conditions, but it’s clear that the need is much bigger than that.
We talk a lot right now about needing more access, but most importantly access to the right, appropriate, high-quality care. That’s some of our findings – that folks benefit from care navigation and the care team approach.
One of the things MinuteClinic is fantastic at is that we can augment and work with a person’s primary care provider, or work with other folks that might be in their lives, which is often the case with mental health. Mental health often doesn’t occur alone.
We also know the need is much greater, and we’re just beginning this journey. 80%, on average, of the patients we treat have reported a reduction in depression symptoms. That’s huge for us, and it’s happening in between five to seven sessions. Because we didn’t want to just increase access, we want to increase people’s mental well-being.
Does CVS have plans to expand the number of MinuteClinic locations with licensed mental health clinicians?
Absolutely. Our goal is to continue to expand. The how, when and where is always what takes a lot of thought. I don’t have specifics I can share right now to say, “We will be in these next five states.” But we will continue to expand.
And with the enhancement of our virtual platform, we do think we can continue to grow and serve more communities across the country.
Besides staffing licensed mental health clinicians, how are CVS MinuteClinics addressing patients’ behavioral health needs?
Within MinuteClinic, we can do quite a few things. Some people present with physical health issues. We identify that there might be some mental health concerns too. We can do depression and anxiety screening. We can fill medications, and basic psychotropic medications through our nurse practitioners and PAs, because they’re prescribers.
Patients are whole people; the head is not separate from the body. So starting to understand those relationships and have a care team approach is really important. And we can do that across our footprint and MinuteClinic.
We can start to target and close gaps around mental health care. The large majority of mental health medications are prescribed by primary care doctors, not psychiatrists. We can really have an impact on addressing people’s total mental well-being by really making that a priority in everything we do.
The consumerization of health care is a big driver in the industry right now. How does CVS MinuteClinic think about this, especially when consumers are looking to access behavioral health services?
We have to meet them where they are. And the truth is, is that mental health – it’s complex.
The other thing I’d say is, when we’re feeling down, we often don’t know who to call. Do we call our primary care physician or a psychiatrist? Or, what’s an EAP? An Employee Assistance Program?
We know consumers need to start somewhere. And so when it comes to this consumerization trend, it’s important to meet people where they are and eliminate barriers when we can’t. That means streamlining patient onboarding, making it easy to schedule appointments and reduce those wait times. Because that’s often what we find with mental health – by the time I decide I want help, I can’t be seen for a long time from now. And by then, maybe things will change.
It’s focusing on eliminating those access barriers, as well as starting to make sure care is affordable and that it’s high quality – and that it’s delivering an impact.
Because of all the barriers and the confusion, we think the biggest thing we need to do is start to expand our services and directly impact those pain points that we know folks are having when it comes to mental health care.
You mentioned affordability. I know price transparency is a hot topic in health care. How are you looking at that?
We publish retail rates before sessions, and we take a variety of insurance. We are in-network with employee assistance programs.
In most of these communities, we’re not only engaged with the large payers in that region, but we are focused on transparency, and our retail rates are really competitive.
You can be seen and have an assessment, diagnosis and treatment plan for, you know, $129, or whatever the rate is, and then your follow-up sessions. We also offer various time limits – 30-minute sessions, 45 minutes, knowing that cost is key for many people. Taking that guesswork out is important because mental health can seem daunting.
We work closely with payers and EAPs. Many people have access to free counseling that they don’t even know about. So we find it important to just really partner as closely as we can not only with our provider communities, with our patients to make sure they’re educated and know their options.
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