When asked about what I see for healthcare in 2021, my first thought (and hope) was the expansion of behavioral health integration (BHI) and treatment. The COVID-19 pandemic caused fear, stress, depression, and anxiety, especially at the beginning, when there was still considerable unknown. It continued as measures to slow the spread increased feelings of isolation, financial uncertainty with loss of employment or layoffs, and new roles many never planned to have, like teachers to their children. Even more painful, many have also dealt with the horrible grief of losing a loved one to the virus, also contributing to their suffering mental state.
Whether a patient was already managing a behavioral health condition or developed one over time, healthcare providers have the critical role of recognizing and treating behavioral health—in person or through telehealth. Today I want to review the value-based care opportunities Medicare patients have from the Centers for Medicare & Medicaid Services (CMS) and how to make the most out of patient appointments to combat behavioral health challenges during the pandemic and beyond.
Value-Based Care Reimbursement for Behavioral Health Services
Value-based care providers have two opportunities to achieve reimbursement for Medicare patients through behavioral health services: psychiatric collaborative care management (CoCM) and general behavioral health integration (BHI). Both behavioral health models serve a common purpose: to increase the number of Medicare beneficiaries who have access to behavioral health services and produce more coordinated and evidence-driven care centered around the patient. Like other preventative services, behavioral health initiatives provide routine care to Medicare beneficiaries and stay ahead of behavioral condition development and exacerbation. CMS’s behavioral health integration models aim to treat afflicted patients by providing additional psychiatric services and care management to improve their health outcomes. The CMS models help providers identify patients in need of behavioral health treatment and help allocate the time and resources necessary for that treatment. The end goal of BHI and CoCM is to establish a personalized plan of care integrated with behavioral health services and coordinate the most effective course of treatment to address their struggles.
Asking the Right Questions Ahead of Time
CMS offers questions for a patient to ask themselves before going to a first behavioral health appointment and questions for patients to ask their providers about developing treatment plans, coverage, and types of appointments (in-person, virtual, or including other family members, depending on the person’s needs). The core questions are what the patient wants from behavioral health treatment, what concerns are at the root of their feelings (whether their loved ones, their employment, the pandemic, or others), if they have been seen for behavioral health, what did they feel helped or did not, what do they need from their provider, and what the most realistic treatment options are for them. These questions can help lay a foundation for what the patient needs to find mental peace, and a provider can administer the most appropriate assessment to get a better idea of their mental status.
Harmful Symptoms and Tips for Coping at Home Alongside Treatment
Any person, patient or provider, has likely felt some form of stress in the last ten months about the virus. But if it has turned into intense fear, sadness, or anxiety lasting days at a time, they must get help. Part of behavioral health integration is devising the most suitable care plan for the patient to treat them. Often, that includes steps like medications or routine counseling appointments, but especially during COVID-19, there are many resources available to help start mitigating behavioral health triggers at home. Some simple daily practices may be a great starting place to discuss with patients alongside proper treatment. According to the Mayo Clinic, people should take care of their bodies and minds and connect with others to promote positive mental health. Tips to help patients do these things include:
- Maintaining activity and exercise habits, getting enough sleep at night, limiting screen time (especially 30 minutes before bed), and eating healthy foods
- Maintaining a normal routine as much as possible, staying busy during the day, making a conscious effort not to read countless articles or watch the news too often, and focus on positive thoughts, like hope for the future after the vaccine
- Staying connected to loved ones via phone, video chat, and the like, especially those who are at higher risk and are likely isolating themselves more strictly
COVID-19 has brought fear and aggravation to many, and the return to normalcy will be a massive help in the lifting of spirits post-pandemic. I would be remiss not to share some resources below to help providers and patients alike who may need greater assistance.
Christine DiNoia, BSN, RN, is a Clinical Transformation Advisor at Lightbeam.