Access to behavioral health care continues to elude people across the country.

To solve this problem, Highmark Health is taking a whole-person approach to behavioral health, Senior Vice President and Executive Medical Director of Population and Curated Health Dr. Anil Singh told Behavioral Health Business.

The challenge to Highmark Health’s behavioral health strategy is the rising cost of health care services. The key to addressing costs, Singh said, is proactive and preventative care.

To proactively get members with moderate to severe depression into treatment, the health plan launched a program with digital behavioral health provider Spring Health in January. Now, with the first six months of data under its belt, Highmark Health plans to expand the program to include substance use disorder (SUD) treatment and an employee assistance program (EAP).

Pittsburgh, Pennsylvania-based Highmark Health provides health insurance to 6.9 million members in Pennsylvania, West Virginia, Delaware and New York. It is also the parent company of Highmark Inc., enGen, Helion and Allegheny Health Network. Allegheny Health Network is an integrated health delivery network that includes 14 hospitals and more than 2,600 physicians.

BHB sat down with Singh to discuss how to increase the number of clinician “slots,” why now is the right time to launch an EAP and the future of whole-person care in the behavioral health industry. Highlights from the conversation are below, edited for length and clarity.

BHB: What would you like to see change in the behavioral health industry broadly to improve access?

Singh: We’re already doing it. It’s the fact that we’re curating the network to find the highest-quality providers. We’re benchmarking them against quality metrics. It’s not about the number of providers; it’s about the number of slots that are available to make patients. So, for example, I might have eight hours to see patients, but if my slots are filled, it doesn’t matter. But if I had open slots at certain times that allow patients to come into those open slots based on their preferences and time, you begin to match that up. The more that we continue to do that, the better access we’ll have, the better outcomes, engagement and experience we’ll have.

It’s the preferences, the ability to match providers to member needs and desires. Behavioral health is such a private item in somebody’s health care journey that the ability to connect with somebody because of matching preferences and life experiences is just a natural way of leading to increased engagement.

How do health plans and Highmark Health specifically go about ensuring members have access to enough slots?

That’s one of the reasons why we set up our mental behavioral health solution [with Spring Health]; that was one of the key pieces. It was also about increasing our network providers and increasing the numbers, but it wasn’t just about that. Part of the partnership that we have with Spring is ensuring that they have a number of open slots available so that there’s a guarantee that we will see patients within five days. The fact that we’re knocking it out of the park at an average of 1.3 days to appointment is just amazing.

Highmark Health just got data back from the first six months of this digital mental health program. How will the data from the first six months inform changes to Highmark Health’s strategies or priorities in the next year?

We follow leading and lagging indicators, and that helps us determine what goes on our roadmap moving forward. For example, the data that we’ve been receiving already has informed our next tranche of enhancements to the Mental Well-Being solution to include substance abuse, which will start in 2025. We also know that eating disorders are an important piece. Those are the enhancements that we’re leveraging as a result of some of the feedback that we’ve been getting from our members using it and the need that we’re seeing in our members as well.

You’re adding an EAP to the Spring program in 2025. What that’s going to look like, and why is now the right time to move into the competitive EAP space?

There are certain EAPs that are incongruent. They may only be for a short period of time, and then if somebody needs more therapy they may have to go and switch providers. We have this unified approach where our Mental Well-Being solution with Spring Health is offering an EAP and if they need more visits than the EAP provides, it’s a natural continuation. Now you created this trusted environment with the provider that you originally saw, and that seamless interaction and experience with the member and the provider is what makes that unique and really substantial from a patient’s health perspective.

EAPs are a customer need, and people are starting to understand the disparities between EAP versus some other vendor. For those folks that are using the EAP services, there’s somewhat of a dissatisfaction, just inherently, because you start out with one thing, and then all of a sudden you need more help, but you can’t continue on with that provider. Folks are starting to put the two together and say, ‘Well, hey, why would we have two separate ones?’ We should have a seamless experience for a member as they kind of go through that.

How would you describe Highmark Health’s overall behavioral health strategy, and how has it evolved over time?

Our living health strategy is what we call it. It’s really predicated on improved health outcomes or the health of our population of patients. We believe that if we do that, through creating a better experience, and therefore engagement, in members’ health, that will lead to an improved economic outcome. We know, if we improve health, the total cost of care will come down.

It’s whole-person health; it’s that triad of physical, behavioral and social aspects of care and the interconnectivity with all three.

In the past few years, we wanted to put a spotlight on behavioral health. As clinicians, we always knew that there was a need. The pandemic kind of unveiled it and made it open to the public. Highmark Health really began to put the spotlight on it and the idea of creating parity between physical health and behavioral health. It really should be at parity, and we’ve done that over the last several years to the point now where I think that we’re seeing the fruits of our labor.

What does the future of whole-person care look like in the behavioral health industry?

It’s the interconnectivity. I don’t think a lot of folks have been able to create a seamless experience. It feels very fragmented and disjointed. We go see this person for physical, and you see this person for behavioral, this person for social. How do you put all that into one place? We’ve done that through our Highmark app, which is that original digital front door that now begins to collate your insurance side with your health.

What is a headwind and a tailwind for Highmark Health right now?

I’ll start with the tailwinds. Our strategy is the right approach to move us forward: this idea of whole-person health. I feel like clinicians have been doing it all along. I just think it’s taken a little while for health plans to catch up.

The headwinds are certainly cost. As the economy is driving a lot of inflation and people continue to struggle to afford care. The cost of medications such as GLP-1s is astronomical. I anticipate more of those types of drugs will be coming out in the future, and the cost of that could be prohibitive to getting access to patients who actually may need it.

How would you describe your strategies to overcome increased costs?

It’s more proactive and preventative care. Because if you can prevent somebody from getting into that state, then hopefully they never need the medication or inpatient utilization or anything like that. Specifically, in behavioral health, it’s unveiling the stigma and getting people to help. We should make that accessible and easy for people to get into as much as we would with physical conditions.

Looking at the behavioral health landscape, how do you see the role of health plans evolving over the next three to five years?

All health plans will recognize the importance of behavioral health. We’re unique in that we are able to leverage our provider networks as well. We have an integrated system of clinicians and payers. It’s the blending of the two, that allows the richness of not only dialogue but innovation. It’s solving difficult and complex problems and bridging that data together that creates that ability to recognize opportunities. We’re unique in that sense. I do think other payers will have to address behavioral health and larger populations as well.