August 2, 2022

CareFirst BlueCross BlueShield Taps Headway to Help Patients Find Behavioral Health Care Providers in ‘Fragmented Cottage Industry’

CareFirst BlueCross BlueShield Taps Headway to Help Patients Find Behavioral Health Care Providers in ‘Fragmented Cottage Industry’

by Laura Lovett

Original article on Behavioral Health Business here

CareFirst BlueCross BlueShield is teaming up with Headway, a company that matches patients to mental health clinicians, on a new initiative designed to help members more easily find behavioral health providers.

The partnership is reflective of the payer-startup collaboration happening in the mental health space. Like many of these partnerships, this initiative is focused on making behavioral health care more accessible to patients.

“It’s a fragmented cottage industry that’s hard for members to navigate,” Brian Wheeler, VP of provider collaboration and network transformation at CareFirst, told Behavioral Health Business. “We wanted to organize it in a way that was a win for members and a win for our practitioners.”

CareFirst members can now use Headway’s platform to find in-network behavioral health providers. The system is able to show patients provider availability, treatment areas and demographics.

The service also provides members with price transparency, a topic that has grown into a major priority for U.S. health care policymakers.

CareFirst is a nonprofit, independent license of the Blue Cross and Blue Shield Association. It currently serves 3.6 million members and employers in Maryland, Washington, D.C., and Northern Virginia.

Historically, patients seeking behavioral health care had to go through the payer’s list of in-network providers. This could be a daunting task. Patients could make dozens of calls before finding a provider currently accepting patients.

Meanwhile, solo practitioners were faced with a number of administrative challenges.

“If you’re a solo behavioral health provider, you do not have a receptionist, and an office staff and a billing team,” Wheeler said. “You probably don’t have a website, and you probably don’t have your own video conferencing, HIPAA-secure [system] and some of the things that consumers expect.”

Wheeler and his team set out to help fix both problems. They looked for a system that would enable an easier search-and-scheduling function for patients that also eased administrative burden for solo practitioners.

“What we were thinking is, … could we find someone who could organize these solo practitioners under a managed services organization (MSO) type of arrangement. And would we be able to enable them to run their practices more efficiently to give them technology?” Wheeler said. “Then from the member perspective, they appear as part of a group practice on a website with the ability to schedule online to book a telehealth appointment or an in-person appointment.”

Existing in-network providers will be invited to join the network for no cost.

Wheeler said the new system will help independent providers cut down on their administrative expenses. It will also help providers with scheduling. Clinicians will still be able to choose their own hours and be a solo practitioner.

New York-based Headway built a platform designed to connect patients to mental health providers in their insurance networks. Founded in 2017, Headway has raised over $100 million in venture funding. The company recently announced deals with Blue Cross North Carolina. It works with Aetna, Anthem Blue Cross and Blue Shield, United, Cigna, Oscar, Oxford and a number of regional blues.

The partnership will also enable real-time data sharing between Headway and CareFirst in order for the payer to gain insights into the patient experience. The partnership contract is “value-oriented, with fees at risk based on performance.”

“We found a way to work with plans, providers and patients, rather than work outside the system, [or ] work just with commercial entities, work just with employers,” Headway CEO Andrew Adams told Behavioral Health Business. “We truly found a way to work within and with each of the key ecosystem members so we can build a much more inclusive mental health care system.”

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