Make Mental Health Services More Accessible

It’s no surprise that the past two years have presented enormous challenges for families and communities in Michigan. Yet, our individual and shared experiences throughout the heightened stress of the pandemic sparked a shift in how people think about mental health.

It has prompted individuals to evaluate and openly talk about their own mental health, as well as created a greater focus on the importance of investing in resources.

We now have an opportunity to come together, build upon existing services and networks, and increase access to mental health care that could improve early diagnoses, treatment and crisis response where and when a person or family need it.

In her State of the State address and budget recommendations, Gov. Gretchen Whitmer outlined proposals to increase access to mental health services by opening up school and other access points, strengthening the pipeline of mental health professionals to increase capacity for services in a variety of settings, and strategies to ensure that beds are available by strengthening home- and community-based services.

Whitmer’s proposals are exactly the type of action kids and adults throughout our state — whether ourselves or our friends, family and neighbors — need.

Today, the demand for behavioral health professionals’ is universal. We must expand capacity by attracting and retaining enough professionals to reach kids and adults where they are and make sure people have the support they need to prevent a mental health crisis. The proposal to expand the Michigan State Loan Repayment Program for behavioral health professionals is a major step in the right direction to strengthen behavioral health as a career path.

Even before COVID-19, demand for additional staff has been particularly great in schools. We have hardworking, dedicated behavioral health professionals throughout this state.

Last year’s school budget resulted in the hiring of more than 720 nurses, counselors and social workers. However, historically, in-school resources have been scarce, and many people don’t know what behavioral health care resources are available, or how to access services until a crisis leads to an emergency room visit, or interaction with law enforcement.

Adding more resources to schools, including opening 40 school-based health clinics, will give all families greater opportunities to connect children with experts who can equip students with tools to navigate and build resiliency in and out of the classroom.

Whitmer’s proposals to increase school resources and expand the behavioral health workforce would be meaningful next steps that could lead to additional progress in the years to come, including:

Providing additional public education about accessing behavioral health care resources before services are ever needed.

Finding new ways to strengthen the crisis care continuum and, as the state did last year with the expansion of Certified Community Behavioral Health Clinics, further expand service models that make it easier to coordinate physical and behavioral health care.

Encouraging crisis intervention team training for workplaces outside of health care. An example is National Alliance on Mental Illness Michigan’s partnership with law enforcement in communities such as Wayne County to help officers respond to a person experiencing a mental health crisis.

Making sure people who have interactions with law and criminal justice systems get the response and mental health care they need.

Continuing to engage youth in conversations and take action to address their concerns around suicide prevention and other emerging topics.

Everyone deserves easy access to high quality, affordable behavioral health care services when and where they need them, and the Whitmer administration’s proposals put Michigan on a path to being a leader in this space.

I ask other state leaders and the people of Michigan to join me in voicing their support. It’s time to eliminate stigmas that contribute to barriers and make the mental health of Michigan families a priority.

Pandemic proved fee-for-service health care payment model is broken

It’s no shock to anyone reading this that there is an affordability crisis in American health care. And while much of the focus is rightly centered on the cost of services, how those services are paid for also is a factor that influences the pocketbook pressures consumers face every day.

The COVID pandemic continues to spotlight the heroic efforts of those within our health care system — particularly those on the front lines of delivering care.

But it also has confirmed that our traditional fee-for-service payment approach is antiquated and doesn’t serve our population well, especially for providers when they are managing a global crisis.

Historically, insurers like Blue Cross pay physicians, hospitals and pharmacies per unit of service. During the pandemic, services that brought steady cash flow to providers, like office visits and elective procedures, slowed to a trickle. Revenues dropped significantly — precisely when health system resources were desperately needed.

Moving to transform payment to a value-based system — with payments tied to quality, cost effectiveness and patient experience — offers a solution that should diminish negative effects on providers during the next dramatic shift in health care.

Throughout the pandemic, health care providers navigated uncharted challenges, while determining how to safely care for their patient populations.

For example, incorporating telehealth enabled physicians to monitor and care for patients who were isolating at home, but many practices did not have the resources to ramp up those services.

In response, to help our members and their providers, Blue Cross Blue Shield of Michigan advanced $687 million in payments to hospitals and physicians to help maintain cash flow while their fee-for-service, episode-based services slowed or temporarily closed.

But imagine if payment was tied to the quality of care provided and outcomes achieved, rather than volume? If your primary care physician was paid not for every office visit or procedure but for the overall management of your health?

If they had more time to spend with you, to prevent conditions from worsening and prevent the need for costly procedures and hospital stays?

That’s the value-based model.

The antiquated fee-for-service payment model prioritizes volume over value. This model put everyone, especially physicians and hospitals, at severe financial risk during the COVID pandemic.

Value-based reimbursement approaches are not new to Blue Cross. We have been collaborating with providers for over 15 years to reward high quality, affordable care by tying a percentage of payment to specific quality, safety and outcomes goals and the capabilities that produce them.

In 2019, we launched Blueprint for Affordability, a program in which Blue Cross and providers share accountability for patient care quality and cost effectiveness. In this arrangement, providers agree to be paid according to how well patient outcomes are managed.

Models like Blueprint for Affordability progress further into the value-based payment spectrum by tying payment to how well a care system manages the care of the patients they share. These models enable health care professionals to be paid when they collaborate with each other to coordinate quality, affordable patient care, deliver preventive services, and avert avoidable hospitalizations and complications.

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