Employer Best Practices to Optimize Behavioral Health, Telehealth Coverage

Ensuring that employees have the assistance and tools necessary to meet telehealth and behavioral health demands is vital to promote safety and health amid the pandemic, along with lowering or eliminating out-of-pocket costs that can steer people away from cancer screenings, therapies, or aspects of high-value care, said Candice Sherman, chief executive officer of the Northeast Business Group on Health.

Transcript

AJMC®: Hello, I'm Matthew Gavidia. Today on the MJH Life Sciences’ Medical World News, The American Journal of Managed Care® is pleased to welcome Candice Sherman, chief executive officer (CEO) of the Northeast Business Group on Health, or NEBGH, who will speak on a recent guide by her organization titled, “Pandemic Response, Recovery, and Planning:  Lessons Learned for Employers in 2020.”

Great to have you on, Candice, can you just introduce yourself and tell us a little bit about your work?

Sherman: Yeah, thanks, Matthew. And thanks so much for having me, it's a pleasure to be here. Again, I'm Candice Sherman, CEO of Northeast Business Group on Health, and we're an employer-led coalition of health care stakeholders devoted to making health care better for all of us.

AJMC®: Delving into our topic today, the COVID-19 pandemic has brought several pressing issues for employers and their respective health benefit managers to monitor and address through their health plans, particularly availability of telehealth and behavioral health services.

Can you speak on best practices that have been developed during the pandemic to integrate these services and other aspects related to promoting safety and health in the workplace?

Sherman: Sure, so telehealth was trending before COVID-19, but the pandemic really accelerated it. Telehealth is here to stay for sure, and especially with behavioral health, employers need to work with our health plans to ensure that reimbursement is platform neutral.

Providers should be paid the same regardless of whether services are provided in person, by video, or by telephone. And employees need an array of behavioral health options. So, access to health plan networks just isn't enough, especially now. So, making sure that employees have access to a robust EAP [employee assistance program] digital therapeutic and self-care tools, and even coaching can be very important.

I guess another point I would make is that health care stakeholders recognized early in the pandemic that out-of-pocket (OOP) costs could affect people's decisions about getting COVID-19 testing, treatment, and vaccination–what we'd call high-value care.

So, the same consideration should dictate lowering or eliminating OOP costs for other categories of high-value care. For example, things like cancer screenings and drugs and services that prevent and treat the progression of chronic diseases.