Working Well

The Roads Not Taken: Quality and Access in Mental Health Care

AT&T and Equity Healthcare serve as two mini-case studies for how employers can seek to improve quality and access in mental health care.

The Catalyst for Payment Reform recently held a virtual forum on “How Employers are Demanding Better Mental Health Care” on May 1.

As May is Mental Health Awareness Month, I found a lot of this information to be very valuable, especially the speakers who spoke about the access problem and the quality problem. I enjoyed these examples as basically mini case studies to show you what some employers have been doing in this space.

Also Read: “Why Mental Health is a Top Talent Issue”

Matt Phillips, director of benefits at AT&T, spoke about how we can remove barriers to access. He defined access with a couple measures: time and location. So, an employee’s ability to find an in-network vs. out-of-network mental health care provider is significant, but so is their ability to get an appointment in a timely manner.

Phillips outlined AT&T’s challenge, which was that it had 600,000 people covered in its group plan, and these people were geographically dispersed. In many cases, there was a lack of in-network providers for rural employees. And even for even for employees who had access to those providers, they often found that either the wait was too long or that provider was not accepting new patients. Having to wait several weeks to get the necessary care just wasn’t acceptable, Phillips said.

Also Read: “What Does Your Company’s Health Care Plan Say About Your Attitude Toward Mental Health?”

AT&T’s solution to this was to partner with a carrier to create a preferred provider network and work toward two major goals related to the two problem areas explained above. One of their goals is to set a high bar for speed of care, and to ensure that 80 percent of the in-network providers are accepting new patients and that employees don’t have to wait more than 10 days for that first appointment.

I don’t know the results of this (I believe this strategy is still in progress), but what struck to me about this AT&T example is how ambitious and strategic they were. Yes, making such large changes in a health care plan that impacts so many people must be a daunting task, but ultimately, it’s respectable when a company is willing to make a major change and strive for something more effective.

Michelle Harika, chief clinical officer at Equity Healthcare, spoke about how to measure and improve quality. What fascinated me is that it just seems like such a gargantuan task to measure the quality of so many health care organizations. Is there a consistent way to do these measurements so that all these organizations are measured on the same scale? How does a company get honest feedback on a topic that can be sensitive like mental health? Harika shed some light on it.

Also Read: “Is Your Workforce Happy?”

Many factors contribute to the quality problem, she said. Clinical quality measurement in the mental health space is still new. There’s inconsistency in how health care organizations screen for depression and how they use their clinical data. Also, employees/health plan members can’t access a provider’s quality when they’re trying to pick a provider to see, and that may lead to them having an unfortunate experience with a provider that they could have avoided.

Some of the examples she gave of negative employee experiences, via confidential feedback, were baffling: a provider wearing PJs and slippers while they’re seeing a patient; a provider seeing a patient in a non-private room of their home … . Not exactly something you’d want to encounter when you’re trying to get help.

There are several practical solutions employers can use to address their own quality issues, Harika said. First, employers should ask vendors exactly how they already do evaluate quality measures and should push them to hit evidence-based standards if necessary. Also, ask vendors what they are doing with those measurements. Are they removing low-quality providers? Don’t be afraid to ask questions.

It’s also important to provide health plan members — employees — a confidential way to report their experience at a mental health provider.

Harika recommended that we need to continue to push for standardization, both in how medical professionals screen for mental illnesses like anxiety or depression and in how we measure the quality of a provider. Looks like we’re not there yet, but this will definitely be a trend on my radar now.

I found these speakers to be practical and informational, and I hope you did as well! Feel free to share below if your organization is doing something innovative, unique or successful to address quality or access problems in your organization.

Andie Burjek is an associate editor at Workforce. Comment below or email editors@workforce.com.