Insurance company uses “remote behavior” health platform to test the waters

Insurance company uses “remote behavior” health platform to test the waters

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Supporting telemedicine companies is nothing new for insurance companies, but the windfall of COVID-19 and the surge in demand for mental health care during the pandemic have prompted payers to turn to virtual treatment platforms as a way to reduce costs and provide better A way of profit.

Digital tools improve access to care and reduce the stigma surrounding behavioral health, which is one of them most trendy Chronic diseases in healthcare.

Robert Garber, a partner at 7wire Ventures, said that health insurance companies see remote mental health components as a way to improve members’ consumption experience.

In 2021, large insurance companies’ Investment weapons Compared with previous years, their financing rounds for “remote behavior” health companies have increased significantly. Cigna Ventures invested funds in the virtual platform Octave and gingerOptum Ventures of UnitedHealth Group invested in Alma, Brightline and Rey, and Centene provided funding for Vida Health.

Stoddard Davenport, Milliman’s healthcare management consultant, said: “There is a lot of new funding and activities in the entrepreneurial field.” “2021 will be a landmark year for investment funds for such activities.”

Davenport said that because the behavioral health sector has been facing long-term challenges such as supplier shortages, access issues, and payment differences, the time is ripe for experimental digital solutions.

Most large payers have contractual relationships with or invest in telemedicine companies that provide behavioral health services. This makes many smaller virtual platforms clamor to provide their services within insurance coverage, either joining the network or becoming a care management provider.

Davenport said: “Virtual behavioral health companies need to fight hard to show payers the value and impact they bring.”

Jared Augenstein, director of Manatt Health, said that health plans are seeking to improve access to behavioral health services within the network and encourage more coordination of care through structures that limit fragmentation.

Garber said that the existing reimbursement model means that patients do not have to pay for mental health care out of pocket, and insurance companies hope this will increase member satisfaction and retention, reduce costs and improve outcomes.

“They also want to make money, but they are obviously thinking:’How can we improve the care of the entire patient?'” Garber said. “This needs to be integrated into a comprehensive care model. It can’t just be about physical health; it must also be about emotional health.”

Oleg Bestsennyy, a partner in McKinsey’s health care practice, stated that insurance companies want to reduce anxiety and depression and manage long-term costs for policyholders—especially where Medicaid participants and other mental health burdens are considerable Among the crowd-companies that will bring high return on investment

Bestsennyy said that in most cases, health insurance companies tend to launch virtual behavioral health solutions on a small-scale pilot basis to reduce risk, and then figure out how to allocate resources more widely.

Garber said that before directly entering the investment phase or adding a platform to their network, health plans usually look for clinical data to support their decision-making. He said that the least risky option is to work with behavioral health companies to provide services to large, self-funded employers that bear the risk of care costs.

Although the growth phase of the telebehavioral health sector is still relatively early, their adoption rate is high, mainly due to the decline in healthcare utilization during the pandemic, and insurance companies have money to spend. Outside of COVID-19 careThe company is using these funds Strategic investment, Garber said.

Joanne Walker, a research professor at the Georgetown University Health Insurance Reform Center, said that successful virtual treatment companies should increase affordability, limit cost sharing, and provide coordination with primary care and other providers.

Ogenstein said that the health plan’s support for the virtual treatment platform reflects their investment in their own provider operations and remote behavioral health capabilities.

“Payers may be in a leading position and really start to introduce these digital therapists on a large scale, not only to help members better solve mental health problems, but also to reduce avoidable medical deterioration,” Bestsennyy said.

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