Providers, payers, and regulators are all taking a closer look at behavioral health assessments – and with good reason.
Here are five things to know, from the goal of increased adoption to the benefits and financial impact for providers.
Why does nearly every appointment involve checking a patient’s vital signs? To screen for concerns that need immediate attention—and to develop a running record that supports the effective diagnosis of a chronic condition.
Assessing behavioral health is no different.
When all providers offer behavioral health assessments, there’s a greater likelihood of catching concerns even if the patient doesn’t proactively seek out a behavioral health provider. Ultimately, assessments mean more eyes on the patient’s self-reported wellbeing, and more ears attuned to any cry for help, no matter how faint.
Standardized assessments also give providers a way to track changes in their patients’ behavioral health. Over time, the aggregated results create a cohesive record of the patient’s self-reported behavioral health – a vital resource for diagnosing chronic behavioral health conditions.
Electronic, self-administered behavioral health assessments give patients an easy, low-stress way to provide honest answers about what they’re experiencing. Rather than being asked to describe their symptoms or behaviors face-to-face, patients simply answer multiple choice questions on a tablet. The results can be automatically scored and made available to the provider for review.
Remember, some patients might be embarrassed or hesitant to ask for the help they need, especially if they’ve never sought help for a behavioral health condition before. Others might not know how to talk about behavioral health—so they shy away from bringing it up. Still other patients might not even realize that mental illness or substance abuse is impacting their overall health and wellbeing. Whatever the reason, the right questions—presented in a patient-friendly format—help uncover concerns that otherwise would have been missed.
Physical and mental health are intertwined. Behavioral health directly impacts physical wellbeing. And physical ailments, including chronic disease, can precede and in some cases precipitate mental illness—which in turn complicates the treatment of the physical condition.
Data points included in a recent Modern Healthcare article underscore this relationship:
Between 15％ to 30％ of people with diabetes also have depression, resulting in worse outcomes, such as higher body-mass index and increased risk of other conditions (e.g., coronary artery disease, cerebrovascular disease, and microvascular complications…).
Up to 33％ of those who suffer a heart attack later experience depression.
Comorbid depression affects 15% to 25% of people with cancer.
[Data provided by Navigant.]
Seen in this light, identifying and treating behavioral health conditions is a vital aspect of disease management for chronic physical diseases. When the former goes unrecognized or untreated, it undercuts the efficacy of treatment plans for the latter. For example, a patient suffering from untreated depression will likely find it more difficult to engage in regular exercise—a critical aspect of care plans for diabetes and cardiovascular disease.
Given the impact of behavioral health on overall patient wellbeing, it’s no surprise that payers are looking for ways to incentivize behavioral health assessments. Payers want providers to conduct these assessments—so commercial and government payers typically reimburse assessments as a billable service, in hopes that more providers will offer them.
It’s also not surprising that the incentives reflect a preference for electronic assessments, as opposed to paper-based versions. Electronic versions can be scored automatically, eliminating the time-consuming manual process that so often leads to a backlog of unscored (and unexamined, and unpaid) paper-based assessments. Automatic scoring also increases the likelihood of a provider reviewing the results in a timely manner—so patients whose results indicate concerns are less likely to slip through the cracks.
All of this is why payers reimburse electronic assessments at a significantly higher rate—typically 3x or more than the rate for paper-based assessments.
Assessing and monitoring behavioral health is also a key metric for value-based care initiatives like MACRA and MIPS—and the commercial payer programs that mirror these government efforts. The thinking is the same as what’s behind fee-for-service incentives: catching behavioral health concerns as early as possible leads to better outcomes, more effective cost containment, and more efficient health-system utilization.
As payers continue to shift toward value-based payment models, the ability to seamlessly incorporate behavioral health assessments into primary and specialty care will take on greater and greater importance. In fact, providers of every type shouldn’t be surprised if—or, more likely, when—assessing behavioral health becomes par for the quality-reporting course. A patient- and provider-friendly assessment solution lays the groundwork for meeting these quality metrics. More important, it reduces the risk of undiagnosed or untreated mental illness and substance abuse—which is something everyone can get behind.