Initiative integrating medical and behavioral health

A female patient speaks with her doctor.

What does it mean to integrate medical (physical) health and behavioral health? Humana’s vision is to support and provide care for our member population from a holistic perspective. Physical and behavioral health often overlap and connect to one another. For example, members with a physical health condition may experience depression or anxiety, directly or indirectly related to their physical health condition.

What does integration look like to Humana?

Through a recent Healthcare Services podcast, Dr. Phil Painter, chief medical officer for Health Care Services (HCS), shared that Humana has a significant amount of data that shows our members have both physical and behavioral health conditions. Humana has data to support that members who have significant behavioral and physical health conditions are more likely to visit the emergency room and are hospitalized more frequently and at a higher rate.

Behavioral health services have been incorporated into the larger HCS organization from a previous subsidiary called Humana Behavioral Health. Humana is currently working in a number of ways to restructure Health Care Services (HCS) with the capabilities that existed within Humana Behavioral Health, Painter said.

One of many ways we are demonstrating integration is with the Integrated Medical and Behavioral Health team (IMBH). Care managers who have special skills and knowledge in physical and behavioral health conditions allow members a single point of contact. Trained care managers identify patterns and indicators that members face with serious health issues. Finding relatable ways to create a safe environment for the member to share their experience allows the care manager to listen and identify challenges that may be connected to behavioral health conditions.

Another level of integration is through the strategic use of medical directors who report to Dr. Phil Painter to assist with both utilization management and work with our regional medical directors and teams to ensure both physical and behavioral health concerns are getting the appropriate treatment with the right type of providers and medications.

An innovative integration effort is the addition of a web-based assistance program that delivers cognitive behavioral therapy. Programs like this and other web-based initiatives are now residing within Health Care Services innovation areas to explore and develop more online services. This will extend our reach to serve and support our members and their needs especially in areas where there may be a practitioner shortage.

Humana is privileged to offer and expand services for behavioral health within HCS through an integrated model. The activities shared in this article and many more; focus on members who have behavioral health conditions and those who have a comorbid status (physical and behavioral health conditions) to make sure they are addressed appropriately and timely by the right type of providers with the right level of care and interventions.

HCS associates encourage and empower members to discuss their challenges with their providers, which will assist them with ensuring that they are receiving holistic care for their conditions. Elevating behavioral health care for all members is a major goal with this approach. Supporting an individual collectively across the care management and care delivery systems will provide a streamlined experience for the member and for the providers we work with.