The mental health crisis afflicting America is well documented, and we see its impact on our members every day. We see the crisis holistically – surging demand for professional care has run head-on into a shortage of care providers. People are waiting for care, and the system of care is inadequate to help them.
One in five American adults experiences a mental illness each year – yet less than half receive treatment.
Demand for help is straining a limited system. There are national shortages of qualified behavioral health providers, which the U.S. Government Accountability Office estimates will last through at least 2030.
Michigan is among the top five states with the largest number of designated mental health professional shortage areas. Just 36% of the need for mental health services in Michigan is being met.
Addressing these shortages is a priority for Blue Cross Blue Shield of Michigan. Inadequate access to qualified behavioral health care services means that our members may not only struggle through everyday life – but also become more at risk for developing chronic conditions that can affect their physical health for years to come.
To many of our members, the care provider shortage can easily be viewed as an insurance issue. Since the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was passed in 2008 to ensure equal coverage of treatment for mental illness and addiction, Blue Cross has fully complied with all the mental health parity requirements in federal law. We also support Michigan Senate Bill 27, which would codify those requirements into law in Michigan.
Our members ask why, when the law requires behavioral health care to be covered, they must wait weeks or months to see a qualified care provider.
We have taken several steps to address their concerns:
- We place equal value on coverage for mental health and physical health – and we pay surgeons and psychiatrists the same rate for their professional time.
- We are addressing the shortage of care providers by expanding access through our strong network of primary care physician practices. Our Collaborative Care program integrates behavioral health care into a primary care practice – meaning patients can get screened for their mental health faster and get into treatment sooner. More than 1,100 providers at 213 practices have started offering this program in the past three years, and more than 20 pediatric practices have joined as well. Doctors say the model is working to get children and teens faster access to the medication and treatment they need to manage conditions like anxiety and depression. For more, you can watch this video.
- We are expediting access for our members by expanding virtual therapy. We added more than 2,000 licensed therapists to our national network to help members through AbleTo, a virtual behavioral health provider.
- We are successfully addressing the mental health care crisis in our communities – including the opioid addiction epidemic. Blue Cross has been working with the State of Michigan and other agencies to make Medication Assisted Treatment (MAT) for opioid use disorder available to patients in practices across Michigan: 63 of Michigan’s 83 counties now have a primary care provider offering MAT. The use of MAT increased 66% from 2020 to 2022, and opioid overdoses in Michigan have decreased 23%.
- Blue Cross is helping to lead the first statewide initiative of its kind in which behavioral health and primary care providers across Michigan are collaborating to improve access to suicide prevention practices. More than 500 health care providers in Michigan have signed on to implement evidence-based suicide prevention practices to improve access to behavioral health services for patients.
- For some of the most vulnerable in our communities, mental health care can be out of reach. Our philanthropic efforts target grants to the ground-level organizations that make the biggest impact. We fund social emotional learning for students in schools through the Building Healthy Communities program. And we’re the single largest private funder of Michigan’s free clinics, helping support the uninsured or underinsured with free or low-cost medical, dental and behavioral health care.
- For urgent mental and behavioral health situations, Blue Cross and Blue Care Network members can see someone face-to-face within minutes, 24/7. Mobile crisis services are available to meet members where they are – at home, at work, school or at the doctor’s office. Walk-in care for psychiatric urgent care, virtual services, crisis stabilization and residential crisis treatment programs are available for children and adults through participating facilities in communities. We’ve expanded our benefits to include intensive outpatient services for adolescents after school. And we’re helping children and adults with severe depression, psychosis, severe childhood issues and continued suicidal ideation with intensive “wrap around services” through community partners.
There is so much that has been done. But there is so much more we need to do. As a nonprofit mutual insurer, we carry the responsibility of being a good steward of the financial investment our customers and members make – which means we are always evaluating the medical evidence and effectiveness of treatments and practices, so care is delivered at the right place, at the right time, to achieve the right outcomes for patients.
Sometimes, denial of insurance coverage leads to frustration, as treatment sites that may be preferred by families and their psychiatric providers are not paid for by our health plans. Sometimes, this is because these practices lack proof of the clinical effectiveness of their treatment. Other times, it is because the provider has refused to contract with us for payment.
Overall, we at Blue Cross Blue Shield of Michigan remain committed to continuously evaluating psychiatric and behavioral health practices and working to contract them into our network of care providers. Given the national and state-level shortages of qualified care providers, we are making every effort to expand access, promote quality care and ensure our members get the support they need to live healthy – body and mind.