Health plans are always striving to ensure their high-risk populations receive the appropriate care when they need it most. Many health plans aim to reduce unnecessary ED admissions and readmissions and improve their member access to community-based providers for post-discharge care and reduce the cost of care.
This commonly shared goal for health plans isn’t always as straightforward and attainable as they would like. There are several pain points that many health plans encounter that can make it difficult for members to access the treatment and resources needed for favorable member outcomes.
Some common issues health plans may encounter include:
- Lack of transparency into member care, especially members entering care through the ED who miss follow-up appointments with a referring provider
- Unnecessary ED boarding and readmissions for members with behavioral health disorders
- Lack of awareness in member referrals needed for clear care transitions
The demand for member access to behavioral health care has hit a critical point in history. Since the onset of the COVID-19 pandemic, there has been a 50% increase in behavioral health conditions, and the U.S. spent $225 billion on mental health treatment in one year. The increase in behavioral healthcare treatment has resulted in increased costs for health plans, as members with high mental health costs incur over 30% more costs than other high-cost members.
Today, health plans are looking for more ways to utilize technology to become better informed about member activities including referrals, time it takes for them to receive care, and how to reduce the overall cost of paying for member care for those who have behavioral health conditions.
Access to care coordination technology that centralizes treatment resources, improves the timeliness of quality care, and offers visibility into care transitions and reporting quality metrics can alleviate this burden. By utilizing technology solutions, health plans can reduce overall care costs, and most importantly, become more informed about the care of their members.
OpenBeds®, our behavioral health solution, offers the technology health plans need to improve care coordination for their members. With these specialized features, OpenBeds allows health plans to facilitate rapid transfers and referrals and foster collaboration among medical and behavioral health providers and substance use programs.
Here are some key benefits OpenBeds can offer to health plans and members:
- Connection for behavioral health providers to a single referral management network that supports care collaboration among providers
- Real-time alerts to care managers when members have an acute care event for accurate tracking and coordination of follow-up care
- Simplified referral process that quickly and efficiently connects members to behavioral health treatment providers
- Closed referral loops by alerting care managers when their referrals are accepted by an approved treating facility or outpatient provider
- Added visibility and reporting for transitions of care and quality metrics, including HEDIS measures
- Real-time insights into member utilization and provider process measures to monitor network performance
Under our trusted referral network, OpenBeds allows health plans to build and engage their own network of treatment facilities and providers. From referral to placement within minutes, members receive more timely treatment, providers experience reduced administrative burden, and health plans see lowered cost of care.
It takes a village to improve the state of behavioral health in the U.S. That’s why health plans play an integral role in helping individuals access the treatment they need, right when they need it. With OpenBeds, a comprehensive solution that closes referral loops and expedites behavioral health treatment placement, health plans can feel confident they are helping members in the best way they can.
If you’re interested in learning more about how your organization can benefit from OpenBeds, contact us today.
