Considerations for personalizing behavioral health

A next-generation approach for behavioral care navigation and support is necessary to help members get the care they need sooner.

Plan sponsors are seeking new ways to connect members with providers, quickly, despite reports of an industry-wide shortage of trained behavioral health professionals. An effective way to do so is to provide members a personalized journey with real-time engagement and care navigation, guided by measurement and support.

The need to simplify the behavioral health navigation experience

Behavioral health plays a critical role in a member’s overall health, including physical vitality. When a behavioral health problem goes untreated, physical health often suffers. That’s why it’s important to match members to the right resources at the right time, with measurable outcomes. However, even finding the right care can be challenging since the average delay from the onset of mental health symptoms to treatment is 11 years.

This delay can have severe downstream impacts, since without timely intervention, health problems can escalate into more serious and costly conditions. A guided experience to alleviate confusion about how and where to find care is critical. Not only that, decades of clinical data have also shown that members who build a sustained relationship with their health care provider achieve better outcomes.

Early identification for behavioral health services and treatment

There are two ways that members can be flagged for behavioral health care: they reach out for help or they’re identified through predictive analytics.

Once they are identified, however, it’s important to act quickly and build tailored, personalized paths. The path should include an assessment, whether through a digital tool or a care navigator, followed by finding the right care and provider as quickly as possible.

A preliminary assessment should determine the urgency and nature of the member’s need for treatment and offer continuous support through the treatment journey. Missing any of these steps and a lack of support can result in downstream impacts, including worsening of conditions and an increase in costs to the member and the plan

Continuing behavioral health services and support in real-time

Combining high-touch service, fast access, support, and navigation helps members access the right care at the right time. These resources include:

  • Providing in-the-moment support with an on-staff clinician to help members and their household understand the complex behavioral health ecosystem and access the best care for their needs, regardless of the condition
  • Support with finding an in-network provider who has open appointments, virtually or in-person
  • 100% follow up to ensure members are taken care of and to provide additional support

Once a member is connected to a provider, the journey isn’t over. A data-driven approach should allow plan sponsors to shift and adjust the member’s path in real-time to help them stay or get back on track, while closing critical gaps in care and saving plan sponsors on total costs.

Download our 7 Steps to Better Behavioral Health report to learn how to help members navigate to better behavioral health care.

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Evernorth Behavioral Health
Evernorth’s data-informed approach to behavioral health provides personalized and customized care across the entire continuum for the populations we serve. These solutions predict emerging health needs, close gaps in care, and drive cost savings—all while empowering whole person and whole family health.