OPEN MINDS Survey Reveals 97% Of Health Plans Support Specialty Coordinated Care Programs – Up from 73% in 2019, 23% in 2017

New case study by Otsuka America Pharmaceutical, Inc. explains how integrated care models are reshaping behavioral health delivery and financial sustainability

Gettysburg (March 13, 2022) — Almost all health plans (97%) in 2021 support specialty care coordination programs, up from 73% in 2019 and 23% in 2017, according to a new case study by Otsuka American Pharmaceutical, Inc. In addition, 98% of health plans say they offer payment for co-location of collaborative care models in 2021, up from 71% in 2019 and 15% in 2017. What this means is that the health care industry is now fully supportive of integrated care programs for complex consumers.

Also known was whole person care, transmural care, coordinated care, or holistic care, the basic premise of integrated health care is the systematic coordination of mental health care with physical health care. This “integration” is changing the competitive advantage for health and human service provider organizations—and with it, changing the parameters of financial sustainability. Integration brings with it value-based reimbursement (VBR), consolidation, and leverage of new technology.

However, there is no specific definition or single type of integrated care. Integrated care models vary in how information is shared, how services are delivered, and the financial incentives among stakeholders. This case study explains the top 10 models of integration reshaping specialty service delivery.

1. Virtual specialty care embedded in health plans.
2. Vertical specialty health plans.
3. Primary care services with tech-enabled specialty care.
4. “Virtual” hospitals and telehospital medicine.
5. Children’s coordinated care.
6. Health plan/health system provision of long-term care.
7. Expansion of the retail health concept.
8. Health plan-sponsored, tech enabled in home primary care.
9. Health plan/accountable care organization/health system risk alignment.
10. Fully integrated health plan/health system models.

Trends In Behavioral Health 2021 Case Study is published free of charge on PsychU.org. The case study is part of the Trends in Behavioral Health Guide, Third Edition (The Guide) published earlier this year.

About OPEN MINDS

OPEN MINDS is a national leader in market intelligence and management best practices focused on organizations serving consumers with chronic conditions and complex needs. Our unique approach is based on focus and synergy:

First, we stay exclusively focused on a very specific set of domains in the health and human service field – mental health, addiction treatment, chronic disease management, intellectual and developmental disabilities services, disability supports and long-term care, children’s services, juvenile justice, corrections health care, and social services. We have deep knowledge of these market areas – and the $860 billion in spending in each.

Second, our unique structure and variety of services fosters a unique synergy between market intelligence and tradecraft. Our team is research-based at its core – with 40+ team members dedicated to tracking every market development, government contract, legislative change, payer, and provider organization in the field. We combine this wealth of market research with a national team of seasoned executives, subject matter experts, and strategic analysts with ‘on-the-ground’ management experience to provide real-world insights and solutions to the organizations we support.

For over three decades, OPEN MINDS has been the ‘bridge to business success’ for thousands of organizations in health and human services. We understand and interpret the implications of changing policy and changing science – and how to navigate and leverage those changes for organizational sustainability and success.

About The Trends in Behavioral Health Series

The Trends in Behavioral Health guides provide information and insights into the multi-layered United States behavioral health system. They include in-depth view of current statistics, prevailing issues, and emerging trends in order to inform the discussions, debates, and decision-making of policy-makers, payers, providers, advocates and consumers. The complete Guides address current behavioral health care trends topics, including:

• A look at the national policy that is shaping the U.S. health and human services market
• A view of the state behavioral health delivery systems that were created by a combination of historical practices, federal and state policy, and market factors over recent years
• An examination of the practices of health plans that manage both physical and behavioral health care for the vast majority of the U.S. population
• A deep-dive into behavioral health care access and delivery of care from the consumer perspective

The Guide Updates provide concise summaries of major changes occurring in the industry. These include high-level impacts of situations affecting behavioral health care (such as COVID-19), new trends, policy changes, and much more.

About PsychU

PsychU members share one simple belief: improved information, increased collaboration, and ongoing discussion will lead to improved mental health care and patient outcomes for individuals with mental illness. Over 64,000 health care professionals who provide, regulate, or administer mental health services are part of the PsychU community. Membership is free and provides complete access to all programs and resources on PsychU.

PsychU is supported by Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC), Otsuka America Pharmaceutical, Inc. (OAPI), and Lundbeck, LLC., and is managed by OPEN MINDS – committed supporters of the mental health treatment community. Editorial development and support for PsychU is provided by OPDC, Oxford Pharmagenesis, Inc., MedThink SciCom, a division of MedThink Inc., and OPEN MINDS, who have been compensated for their services.

Learn more about the community, or become a member today by visiting www.PsychU.org.

For additional questions and inquiries, please contact Murray Beachtel, Senior Consultant, OPEN MINDS at 717-334-1329 or openminds@openminds.com.