Dating slang is helping behavioral health professionals describe a troubling evolution in payer relations. Payer ghosting. In dating, someone “ghosts” another person when they abruptly stop communicating despite previous interest. In this context, payer ghosting occurs when payers stonewall providers on claim reimbursement. This can be a trickier challenge for providers than the typical payer […]
Payers are trying to figure out how behavioral health fits into the value-based care paradigm as the demand for innovative contracting grows. One of the main places payers are pushing for integration is with primary care. Still, integrating primary care and behavioral health in a value-based care arrangement can be difficult. Primary care providers often […]
Behavioral health parity is a critical issue for providers, payers, clinicians and patients. One payer is taking a strong stance by creating an executive role focused on parity. Blue Cross Blue Shield of Minnesota named Brett Hart its new vice president of behavioral health and mental health parity. This is a new position for the […]
Digital behavioral health company Talkspace (Nasdaq: TALK) is on track to achieve profitability by the first quarter of 2024. Part of its strategy for achieving this goal is branching out to a new demographic: teens. Talkspace’s continued focus on its B2B segment resulted in net revenue of $38.6 million in Q3, a 32% year-over-year increase. […]
Cigna’s employer customers are demanding more behavioral health services as rates of anxiety and depression among employees continue to soar. Earlier this year, the company announced that it expanded its behavioral health provider network by 30%, and these efforts are likely to continue. “As we look forward to 2024, we know that in addition to […]
Elevance Health Inc.’s (NYSE: ELV) health care services arm, Carelon, experienced a boost in operating gain in 2023 thanks to the company’s behavioral health business, among other factors. Carelon’s operating gain increased by $9 million from the second to third quarter of 2023, according to Elevance’s third-quarter earnings call. The insurer also announced plans to […]
The Biden Administration’s proposed behavioral health parity rules have received a wave of criticism this week from payer associations and the House workforce chair. Mental health parity, which requires health plans to cover behavioral health on par with physical health care, has been the law for over a decade. But, federal agencies have lacked the […]
Payers have increasingly pushed for measurement-based care, but experts question whether the behavioral health industry has the tools to broadly implement the practice. Measurement-based care, in which clinical data is collected throughout treatment, may increase the likelihood that a patient receives evidence-based care. Implementing the practice requires a whole-person approach that includes contextualization and cultural […]
UnitedHealth Group (NYSE: UNH) has seen a significant increase year over year in its behavioral health care costs. At the same time, the company’s health services organization, Optum, has also seen a large uptick in behavioral health usage year over year. UnitedHealth Group CEO Andrew Witty noted that this trend could have favorable outcomes. “We’re […]
As part of one of the country’s largest ‘payvider’ organizations, Evernorth is positioned to help set the course for the future of integrated and measurement-based care in behavioral health. Evernorth is the health service division of large payer group Cigna (NYSE: CI). It offers a wide range of behavioral health and substance use disorder services. […]
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