How Managed Care Can Help Solve the Mental Health Crisis
By Jason Bearden
A recent Kaiser Family Foundation poll found that 90% of adults believe there is a mental health crisis in the U.S., and more than half of those respondents identified mental health issues among children as the area of greatest concern.
While the statistics about mental health across the country are concerning, those in our state should give us all pause. In Georgia, suicide is the second leading cause of death for children ages 10-17. When it comes to access to mental health care, Mental Health America ranked Georgia 48th in the country for both adults and children.
In Georgia, many of our most vulnerable children are falling through cracks in the system. Children diagnosed with mental or behavioral health conditions who do not have the proper resources often make multiple visits to the emergency room, which can potentially lead to long-term adverse health outcomes.
We know that physical and mental health are fundamentally linked, with physical problems significantly increasing mental health issues and vice versa. In addition, social determinants of health play a large role in influencing health outcomes. To properly address the mental health crisis, we must take all of these factors into consideration. As a national leader in providing quality health coverage - including Georgia's only nonprofit Medicaid plan, CareSource believes in addressing the whole health of our community. We have made it our mission to create and implement innovative programs that make a lasting impact on the health of the members we serve.
That's why we developed CareSource Stronger Together - to not only identify children in need of care, but to also provide a proactive solution that coordinates their care and provides full, wraparound support to keep children safe, healthy and at home with their families. Leveraging our data, resources and partnerships, Stronger Together helps solve the mental health crisis children are facing in our state by identifying, treating and fully supporting children diagnosed with significant mental health conditions.
When low-income families are provided with additional support, they have access to tools and programs to help them thrive, keep them together and improve mental health outcomes for children. Stronger Together develops an individual care plan and includes an in-the-community case management focus that connects children with counseling, medication management, peer support, planned respite care and other traditional and non-traditional support services.
Youth in the Stronger Together pilot benefited in two important areas.
1. Improved mental health outcomes
The CareSource Stronger Together pilot used advanced analytics and predictive modeling to identify children with a mental or behavioral health need, such as major depression, to ensure that they receive the appropriate care. The pilot included 173 children with significant mental health conditions, with a majority reporting suicide ideation. The initial findings showed that prior to the pilot these members were at higher risk for facility-based care and/or trips to the emergency room. They also needed greater case management support.
Throughout the pilot, we saw significant improvements in health outcomes. Stronger Together lowered acute patient admits by 59% and emergency room visits by 19%. These findings highlight the importance of identifying children with a need and providing additional, proactive support.
Other outcomes included:
- Closed care gaps, including dental and well checks
- Initiated referrals to specialty services, such as alternative or nontraditional therapies
- Supported caregivers in their efforts to safely maintain children in their home
- Provided education to clinical staff surrounding at-risk populations
- Implemented in-the-community support by meeting families where they are
2. Additional services for children
Throughout the Stronger Together pilot, CareSource case managers provided additional support to participants and connected them with programs to help meet their specific needs. We partnered with providers and community organizations to offer art therapy, behavioral health services and preventative care.
Specific services provided to children and families included:
- Referrals for intensive wraparound care and art/theatre therapy, as well as forthcoming respite services
- Behavioral health services (counseling, medication management, including peer and parent support, and care coordination)
- Housing support
- Medical and dental preventative care
- Case management specialized training
Together, these services and programs have significantly strengthened family preservation and reunification outcomes across the state, with foster care placements reduced by as much as half. Although services for families increased during the pilot, overall cost of care decreased.
We will continue to support members enrolled in the Stronger Together pilot, but our work doesn't stop there. Due to the success of the pilot, CareSource officially launched the program for families in Atlanta, with plans to increase presence in other communities throughout Georgia. In addition, we believe our predictive analytics capabilities can also be used across other populations to identify those most at risk of negative outcomes and poor health and to design programs to better engage them and meet their needs.
The mental health crisis in our state will not be solved overnight. However, we can work together to identify children in need, listen and provide solutions to improve health outcomes, on child at a time.
To learn more about how CareSource is making a lasting impact across the state of Georgia, visit WholeHealthGA.com.
CareSource is a nonprofit, nationally recognized managed care organization with over 2.3 million members and administers one of the largest Medicaid managed care plans in the U.S. As a mission-driven organization, CareSource is transforming health care with innovative programs that address the social determinants of health, health equity and access to care.
Jason Bearden is the president of CareSource, Georgia.
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