A five-star health plan has launched a new model of care in Bosnia and Herzegovina with increased use of Bosnia and Herzegovina services and the pandemic highlights the mental health state of New Yorkers
New York, December 06, 2021(BUSINESS WIRE)– MetroPlusHealth, New York City’s five-star health plan, today announced the successful completion of its one-year effort to deliver behavioral health services within the company. Now, employees of MetroPlusHealth, part of New York State’s largest provider of BH services – NYC Health + Hospitals – will provide both BH and medical benefits to more than 625,000 members. As New York City continues to recover from the COVID-19 pandemic, the integration of body and mind issues and the coordinated care of both is more important than ever.
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Amid a slight increase in the use of BH services by its members, including a nearly 85% rise in BH telehealth, a recent survey* by MetroPlusHealth found that more than 55% of New Yorkers believe the pandemic has negatively affected their health mental. Moving to in-house BH services will help address the surge in BH-related issues, provide MetroPlusHealth members with a more effective and comprehensive care experience, and will lead to improved medical and mental health outcomes for members and increase the efficiency of the health plan.
The plan’s approach to integrated care has already been a huge success, earning national recognition for its innovation, and in New York State, it is ranked number one in quality. Over the course of nearly forty years, MetroPlusHealth has grown from a small pilot program operating from Metropolitan Hospital in Manhattan to a major health insurance company, covering hundreds of thousands of lives across the five boroughs. Providing Bosnia and Herzegovina services to its members is the latest step forward in the steady development of one of New York City’s largest health plans.
“Behavioral health benefits should be an integral part of our health plans. These services enable us to offer our members a full range of coordinated care,” he said. Dr.. Talia Schwartz, President and CEO of MetroPlusHealth. “Our mission, as a health plan, includes taking care of the whole person. When we care about the body, we can’t just ignore the mind. New York City has always been demanding, and its residents face many stresses. But COVID-19 has imposed new pressures on the health care system, on New Yorkers, and members The most vulnerable too.As a local health plan in New York City and proud New Yorkers, we quickly realized that these times require innovative thinking and approach.Bringing BH home has been one of the most important initiatives we’ve launched during the pandemic.Our members need our full attention to their care, and this includes their behavioral health “.
MetroPlusHealth is committed to treating physical health and behavioral health as paramount to the well-being of its members. Traditionally, these concerns have been managed separately by most health plans, with BH outsourcing to vendors. Over the past 18 months, MetroPlusHealth has done significant work in integrating the behavioral healthcare model, which aims to increase staff awareness and synergy to ensure that members’ physical and mental health issues are addressed together to improve the quality and efficiency of care. Under this new model of care, MetroPlusHealth is now recruiting and collaborating with its network of primary care physicians (PCPs) to identify behavioral health issues on the front lines. This will make PCPs more aware of their patient’s behavioral health challenges and begin effective recovery as soon as possible.
Dr. Schwartz Emphasize the benefits that BH’s new arrangement offers to participating MetroPlusHealth providers. “We believe managing our new BH benefits is less restrictive and more collaborative with providers within the network. Less static approach with usage management and more compatible with our providers through contracting VBP. This difference is not trivial, as credit for savings must be split between physical health and BH, but our new BH model is much more likely to be successful than it was when we outsourced behavioral health. Overall, the move to in-house BH services is great for members, providers, and us to win.”
He said MetroPlusHealth’s decision to move behavioral health to internal management “opens up a new world of opportunities for quality and efficiency that have been difficult to achieve with external partners.” Dr. Sanjeev Shah, Medical Director of MetroPlusHealth. “Having mental health services within the home puts mental and medical health in equal measure and importance. BH affects physical health, and it affects BH physical health. We know that people with BH problems have significantly worse outcomes and shorter lives. After cardiac events Patients often experience depression and anxiety, and treating these conditions may lead to better cardiac outcomes.”
Through in-house services, MetroPlusHealth money market experts can now screen for complications in real time before conditions worsen, eliminating the problem of not getting care due to insurance. They can also supplement medical treatment by addressing social determinants of health such as housing, food insecurity, and employment. “The new BH model,” said Doctor. Shah |“It will make it easier for us to get to know our members, monitor them, and partner with them in the successful treatment of their physical and mental health needs, as well as their social determinants.”
“Our team is working closely with some of the plan’s most vulnerable members,” he stated Anna Rina, LCSW, CCM, Director of the ICM (Integrated Care Management) Task Force at MetroPlusHealth. “It is very exciting to now have an in-house behavioral health department that can support our work with high-risk and homeless individuals, who often suffer from significant mental health and substance use disorders, along with complex medical conditions. These members need help with so many aspects of their care that can be overwhelming and discouraging for people who are already suffering. An internal behavioral health management that understands the challenges of our most vulnerable members, and can help stabilize them, is a huge advantage for our members.”
The integrated BH program from MetroPlusHealth is designed to:
Ensure access to a wide range of services such as Home and Community Services (HCBS), which support life skills acquisition, job training, employment support, social skills, and family therapy.
Child and Family Behavioral Health and Support Services Support (CFTSS), a combination of treatment, rehabilitation and psychosocial services for children and youth under 21 years of age.
Create partnerships dedicated to highly vulnerable groups (eg, incarcerated and formerly homeless), ensuring strong alignment/coordination with city agencies, H+H, and community organizations.
Offer individualized and comprehensive care plans tailored to each member, taking into account BH, the medical and social determinants of health.
Actively communicate with the member’s coordinators and other care providers to ensure health and wellness goals are achieved. Care coordination activities will be the basis for care plans and promote individual responsibility for health awareness.
Work with the provider community to provide member-specific feedback.
The Metroplus Hospital Health and Patient Outcomes Program will:
Provide a whole person Treatment, prevention, and wellness approaches, including a focus on addressing social determinants.
Reducing the avoidable inpatient and emergency department Benefiting by ensuring effective management of care, usage management and access to quality providers.
boost recovery of substance use disorder through active contact with drug-assisted therapy (MAT) and/or outpatient treatment.
Develop operational agreements with the service provider community to go along with it Effective delivery of evidence-based therapies.
Besides the strong network of BH providers now available to them through their health plan, MetroPlusHealth members can also take advantage of the MetroPlus Virtual Visit. This free 24/7 telehealth program connects them with board-certified therapists and psychiatrists via smartphone, tablet or computer. With COVID-19, it is essential that members always be able to access health services remotely. Virtual visits allow members to get help when they need it, without the stigma and for free.
Many of the mechanisms of BH transmission to an endogenous form may be clinical, Dr.. Talia Schwartz pointed out. “But, ultimately, this transition is about ensuring hundreds of thousands of New Yorkers, our members, and our neighbors have seamless access to the mental health services they need now more than ever.”
Since 1985, the MetroPlus Health Plan has built a reputation for providing access to quality, affordable health care to residents throughout New York City. MetroPlusHealth is the plan of choice for over 625,000 New Yorkers and has a five-star rating based on the state’s 2020 Consumer Guide to Medicare, Child Health, and Managed Care Plans in New York City. The strong network of primary care physicians and health plan specialists includes many independent community care providers. Culturally sensitive, speaking over 40 languages fluently, MetroPlusHealth’s staff is as diverse as the great city it serves. For more information about MetroPlusHealth plans, benefits, and services, visit www.metroplus.org and join the conversation at facebook.com/metroplushealth and Twittermetroplushealth. MetroPlusHealth is part of NYC Health + Hospitals, the nation’s largest public health system. For a list of MetroPlusHealth locations and hours of operation, visit metroplus.org/metroplus-near-you.
MetroPlusHealth’s 2021 Behavioral Health Survey Conducted in September 2021 and consists of two distinct studies with the Geo-CARAVAN Survey conducted by Ingeni Insights. The New York City survey was among New York City DMA residents, ages 18 and older. The General Population Survey was among a sample of 1,011 adults aged 18 and over. The comprehensive study is conducted online three times per week on a demographically representative US sample of 1,000 adults aged 18 years or older.
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