Grow (or Expand) Your Behavioral Health Program
NOW? YES!
Why a global pandemic is the perfect time to start growing your behavioral health program:
4 tips from a finance-minded LCSW
By Ryan Rysyk, LCSW, Senior Associate, Facktor
According to a July 2020 poll, 53% of US adults have reported that their mental health has been negatively impacted by worry and stress over coronavirus—resulting most commonly in increases in alcohol and substance use, difficulty sleeping, and worsening chronic conditions[1]. This comes at a time when 54% of behavioral health organizations have had to close programs and 65% have had to cancel, reschedule, or turn away patients[2]—greatly reducing patient access to much-needed behavioral health care.
Now more than ever, FQHCs, hospitals, community healthcare clinics, and other healthcare organizations are faced with the challenge of providing adequate behavioral health care to a population with rapidly growing needs, all while trying to stay afloat financially. Yet despite these challenges, it’s a good time to grow your behavioral health program. Here are options and guidelines to ensure your behavioral health program is sustainable for you, and supportive for patient mental health needs, during these unprecedented times.
1. Introduce a Brief Intervention Model of Therapy.
In most state Medicaid programs, including California’s Medi-Cal program, FQHC & Look-Alike behavioral health providers are reimbursed at the same PPS rate for all psychotherapy visits regardless of their service code. Essentially, this means each FQHC gets paid the same rate for a psychotherapy session, no matter whether the session lasts 16 minutes or 60 minutes. Traditionally, therapy models have utilized 45-60 minute sessions, allowing providers to see a max of about eight (8) patients per day. However, by introducing a brief intervention model and 30-minute sessions, this number nearly doubles—up to 16 patients per day! This increase in the number of available appointments expands patient access to behavioral health care, all while boosting program revenue—supporting both population health and financial sustainability.
2. Utilize (or revamp) the SBIRT Screening Process…and add ACES.
SBIRT stands for Screening, Brief Intervention, and Referral to Treatment. It uses screening measures to identify at-risk primary care patients and guide them into early interventions and treatment.
Many FQHCs use outdated screening forms for SBIRT—or none at all—limiting their ability to provide integrated care and connect patients to other service lines, like behavioral health. Through the creation or redesign of an SBIRT form, FQHCs can identify patients suffering from conditions such as anxiety, depression, and substance use and connect them to care. In addition, SBIRT forms are a great tool for gathering patient data tied to grants or other funding opportunities.
If your behavioral health program is operating in California, as of January 1, 2020 by incorporating the Adverse Childhood Experiences (ACEs) screening form into your SBIRT process, the California Department of Health Care Services (DHCS) will pay Medi-Cal providers $29.00 per screening for children and adults with Medi-Cal coverage.
3. Perform Warm Handoffs.
Too often, medical providers refer a patient to be scheduled with a behavioral health provider and the patient doesn’t show to their first appointment. This is a major loss for both the patient and for the organization: the patient’s mental health remains untreated and the organization is saddled with a no-show.
A ‘warm handoff’ is a transfer of care between two members of the healthcare team, commonly between Primary Care and Behavioral Health departments. Unlike a referral, a warm handoff goes a step further, where a member of the medical team introduces the patient to a member of the behavioral health team, in person, as part of their medical appointment.
Setting up this initial meeting with the behavioral health team has multiple advantages. Exposing the patient to the program is a statistically proven way to increase their attendance to their first behavioral health appointment[3]. Warm handoffs decrease the burden on primary care providers (PCPs) as they can simply redirect patients that come in with behavioral health needs to a behavioral health provider. This reduces their average patient visit length, opening up additional visits for PCPs, while also limiting burnout.
4. Expand Telehealth Services.
As a result of COVID, many behavioral health providers have moved to hybrid or fully remote services for patient and workplace safety. Organizations have been utilizing telehealth by performing therapy sessions over the phone and through HIPAA-compliant video software programs. Though the initial selection of a platform and general rollout of telehealth can be challenging, there are many ways to ease the transition and to help everyone – patient, clinician, and organization – embrace the new technology and add it to your arsenal of therapeutic settings.
By providing necessary support for clinicians, whether they are providing services in the clinic or from the comfort of their homes, you can ease the transition considerably. When you involve them in transition decisions – for example, selection of a telehealth platform or the differences between electronic screening forms and those used in person, it’s easier for everyone pivot and adapt behavioral health programs to accommodate current needs.
In fact, many organizations that have expanded telehealth services have recouped their previous lost capacity. Many have actually seen a significant increase in behavioral health encounters due to expanded patient access (transportation and distance are no longer barriers, and patients have more flexible schedules) and a decreased no-show rate. Needless to say, while the pandemic will not last forever (hopefully), telehealth services are here to stay.
So to repeat our earlier question: is a global pandemic is the perfect time to start growing your behavioral health program? The confluence of demand, technology, and capability mean that answer is definitely “Yes.” If you don’t know where to start, we can provide guidance and support for sustaining and growing your program to meet patient needs—while also improving your bottom line. Whether it be training behavioral health providers on the Brief Intervention Model, helping you implement or update SBIRT, or helping your organization choose the telehealth platform that’s right for you, Facktor is here to help.
[3] Mauksch, L., Peek, C. J., & Fogarty, C. T. (2017). Seeking a wider lens for scientific rigor in emerging fields: The case of the primary care behavioral health model. Families, Systems, & Health, 35(3), 251-256. doi:10.1037/fsh0000295
