Integrating physical and behavioral health care for vulnerable populations is an ongoing challenge across industry. Two providers are bridging traditional care gaps to do just that.

And they are doing that in home-based models, a care delivery method not typically seen in mental health and addiction treatment — in the home

Nest Health and MiraSol Health have each launched programs aimed at improving access to behavioral health services, moving beyond incorporating telehealth for patients at home.

While the two companies have different patient populations, both approach integrated behavioral health care in the home through the same lens: whole-person, family-centric. Extending these services to caregivers and family members of the primary patients – typically an unmet need – builds a foundation to meet patients where they’re at without the stigma of traditional settings.

Home care redefines patient dynamics

Gretna, Louisiana-based Nest Health, a home-based health care provider for high-risk families, debuted a rarity: comprehensive home-based care for patients with opioid use disorders (OUD). The program, Nest Rooted Recovery, blends in-home clinical assessments, medication monitoring, pharmacy coordination and care management for mental health services with its medical approach to support patients and caregivers.

“Being in the home shifts the power dynamic in a critical way, giving patients and families a sense of agency they often don’t experience in traditional health care settings – instead of asking patients to navigate complex systems or unfamiliar environments,” Kelsie Brandt, chief clinical officer of Nest Health, told Behavioral Health Business.

If follow-up for more longitudinal substance use care is needed, Nest coordinates a warm handoff with either Odyssey House, an in-person residential and outpatient addiction treatment system based in New York, or to Waltham, Massachusetts-based Eleanor Health for comprehensive virtual addiction treatment for patients with substance use disorders (SUDs).

Meeting vulnerable populations where they’re at

Bluffton, South Carolina-based MiraSol Health historically provides palliative, hospice and grief care services. It is expanding its nonprofit operations with the addition of Rays of Hope Behavioral Health. The expansion of services will allow patients and their families to access counseling, group therapy and other mental health support services in person or virtually. The services will be offered to family members through the first 13 months of grief after the death of a hospice patient.

Vulnerable patient populations, like individuals with OUDs or who are navigating chronic illnesses and placed on hospice, already face a multitude of barriers. Bringing this type of wraparound care directly to the home builds a pathway for navigating complex systems.

“Investing in home- and community-based behavioral health support meets patients where they are, providing personalized care that removes barriers like transportation and accessibility. This approach improves engagement, enhances outcomes and reduces overall health care costs by addressing mental health needs proactively,” James Dismond, CEO of MiraSol Health, told BHB. “It’s a compassionate model that’s also cost-effective and sustainable.”

Closing the gap

Both programs, while built for different needs, were born out of the same gap: something was missing in the care continuum.

After consistent feedback from patients, families and staff over a need for more intricate mental health support alongside MiraSol’s hospice and palliative care, “Rays of Hope was created to address gaps in specialized support,” Dismond said.

Its addition is anticipated to improve patient outcomes and strengthen the well-being of families involved in end-of-life care processes.

“By integrating behavioral health, we aim to reduce stress and improve coping mechanisms, ultimately improving the overall care experience for both patients and their loved ones,” Dismond said. “We aim to treat the person rather than just the diagnosis, and help family members navigate the emotions that often come with chronic illnesses.”

Treating the families in addition to the condition is one area Nest Health also recognized as a critical component to improving patient outcomes in its lane of addiction treatment. Integrating medical and behavioral health at home in a single pathway, “improves the long-term health and stability of the entire family,” Brandt said, and allows clinicians to “assess, triage, and treat interconnected issues at once, removing barriers to effective care.”

“In typical in-clinic healthcare settings, care is fragmented, with little coordination between different providers, leading to delays, gaps and missed opportunities for intervention,” Brandt added. “By delivering care in one place through a unified team, Nest makes treatment more timely, accessible, and effective, ensuring that families get the comprehensive support they need when they need it.”

While both providers, MiraSol and Nest Health do offer telehealth services alongside mental health supports, the in-person component of home care they each extend allows for more insight into patient and family wellbeing, the leaders explained.

“Home-based behavioral health support for SUDs goes beyond what telehealth alone can offer,” Brandt said. “Being physically in the home enables our clinicians to build deeper, trust-based relationships with patients and families, which can be difficult to achieve virtually.”

From an ROI perspective, reducing time spent in a hospital while improving family health as a unit will help both providers save on downstream costs and translate to measurable savings more broadly.

Closing the loop on missed opportunities and filling gaps in the continuum of care for patients and families at home via integrating care this way, ultimately creates the environment for “more honest conversations, better engagement, and ultimately, more effective treatment and recovery,” Brandt said.