RESEARCH MONITORING BEHAVIOR: A LONG-TERM LOOK AT HOW PRIVATE HEALTH PLANS ARE DELIVERING BEHAVIORAL HEALTH SERVICES The past five years have seen rapid change in the field of behavioral health due to the passing of two landmark bills: the Mental Health Parity and Addiction Equity Act of 2008, and the Affordable Care Act of 2010. What do these bills mean for the millions of Americans dealing with mental illness and substance abuse? And how do they play out in terms of medical appointments, referrals, prescriptions and the myriad other components that make up our nation’s health care system? Researchers at the Institute for Behavioral Health at the Heller School are working to answer those questions through a series of national health plan surveys that began in 1999. Funded by the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, the health plan surveys monitor how alcohol, drug and mental health services are provided from an administrative and clinical perspective and, just as important, how they’ve changed over time. KEY FINDINGS AND TRENDS
The most recent survey, conducted in 2010, noted key changes in the way behavioral health services are administered. While most health plans previously contracted with outside behavioral health organizations to provide services such as detoxification and counseling, plans have moved to a more integrated approach referred to by the Heller research team
as “hybrid internal.” This arrangement describes how more than two-thirds of the nation’s health plans deliver behavioral health services today (see graph on next page). This positive shift toward integration also extends to clinical care. “More plans said they were doing medical homes [teambased, patient-centered care] or using health risk assessments and health coaching, things that were indicative of plans offering services for behavioral health in a more integrated manner,” says Constance Horgan, ScD, principal investigator of the survey project and director of the Institute for Behavioral Health. Horgan and her research team relate this trend to the Affordable Care Act’s emphasis on primary and preventive care, which had only just been introduced in 2010. “We expect that in 2014 that trend will be much more dramatic,” says Horgan.