ABHW Member Company Spotlight - MHN
ABHW recently conducted an interview with Larry Tallman, President of MHN, about the work MHN is doing with the Affordable Care Act, integration, parity, and other innovative programming on a variety of issues.
MHN is a Health Net company, delivering clinically based workplace solutions to improve productivity for its clients and enhance the lives of its members. MHN’s products range from Employee Assistance Programs (EAPs) and behavioral health services to organizational development and wellness programs. MHN’s solutions promote work/life balance, wellness, employee productivity, and organizational efficiency.
Preparing For and Moving Forward With the Affordable Care Act
To prepare for the Medi-Cal expanded mental health benefits that became effective on January 1, 2014, MHN leveraged its commercial network to build a specific Medi-Cal network in 12 California counties. This network serves Medi-Cal beneficiaries with mild to moderate behavioral health needs. In preparations for new essential health benefits related to methadone treatment, MHN built a network of clinics that treat pregnant women in urban and suburban geographies throughout California.
Asked about the biggest challenges managed behavioral health organizations (MBHOs) face as we move forward with the ACA, Larry noted a few challenges MHN has been aware of, yet feels prepared to tackle: “anticipating and scaling up for the volume of members that have access to coverage under ACA; making sure that all of our systems are ready to support the parity of mental health benefits including the across service accumulators; and focusing our attention on the needs and focus of individual purchasers in addition to the traditional group purchasers.”
Integrating Behavioral Health and Medical Care
Tallman shared some innovative programs that integrate behavioral health and medical care. One is MHN’s Co-Management program the company has established with its medical counterparts at Health Net, where they meet regularly to share data and intervention for members who have concomitant medical and behavioral health challenges. “This is especially true for our new Cal Medi-Connect membership where there are very robust integrated case management technologies and process to work collaboratively with medical and behavioral providers,” Tallman said.
He added, “With the increasing evidence supporting the integration of medical and behavioral health from both a quality and cost perspective, customers want to see how we are integrating with our parent health plan (Health Net) as well as other member medical plans. The challenges to this fall into three general areas: technical, philosophical, and legal.” He explained that in the technical area, integrating care has meant the need to move to the same systems as medical plans and providers or find ways for the systems to talk to one another. He added, “These changes, of course, require time and, often, significant resources.” Regarding the philosophical area, Tallman said, “Many behavioral health providers remain unconvinced of the importance of sharing information about their treatment, or obtaining information about treatment for associated medical problems, with the patient’s medical provider (most often the PCP). Even when they understand the importance, it just doesn’t happen routinely. At times this is because of the reluctance of the member to have this information shared. Many PCPs also do not inquire routinely about a member’s behavioral health care and, when they do, they often don’t request information from this provider.” And from the legal standpoint, Tallman noted, “Many state and federal regulations have been implemented to establish distinct, separate consent
requirements for the release of information specifically related to mental health and substance abuse treatment. Manually obtaining these consents can be logistically difficult in a consistent fashion, so sharing larger data files at the plan level is unlikely to be possible in the current environment. While we are aware of the sensitivity around this issue, the result is that PCPs have access to information about all specialty care that their patients are receiving with the exception of behavioral health.”
Regarding parity, Tallman said, “It really ties to our work on minimizing the stigma associated with mental illness and substance abuse problems. When a person has a higher co-pay or arbitrary session caps on coverage for these conditions, it reinforces the perception that these services are different than those for ‘regular’ medical conditions and possibly not as important. With parity these distinctions go away and members can see that seeking treatment for these conditions is no different than receiving care for any other medical condition.” MHN is implementing parity by focusing on the quality and cost of the care that its members receive in relation to the benefits their plan covers. “For this reason,” Tallman said, “much of the work of preparing for parity has been in updating the benefits configuration in our systems to reflect the new reality. Our clinical and customer service staff is happy about the expanded coverage under parity and love to share this good news with our members when they are working together with them on accessing care.”
Creating Training and Organizational Development Initiatives
Tallman provided an overview of two cases related to MHN’s Training and Organizational Development Initiatives.
- A couple of years ago, following an urgent request from the Governor’s office for assistance in addressing a “suicide epidemic” within the California Highway Patrol (CHP), MHN developed a specialized program. Prior to MHN’s intervention, 14 suicides within a twelve-month period generated national media attention, assigning the CHP with the highest suicide rate of any law enforcement agency in the nation. MHN assembled an internal team of top behavioral health experts to partner with the CHP Commissioner and state experts to gather and identify relevant information on the issues. An MHN Training Department designed a comprehensive five-hour Suicide Awareness and Prevention training program for CHP managers and supervisors. The company also coordinated a strategic program roll-out statewide to identify high-risk behaviors, provide protocols for intervention, and review process details of formal and informal referrals to the EAP. MHN created a dedicated referral line, special intake protocol, designated management consultant, and preferred provider network. It oversaw design and development of follow-up Critical Incident Stress Debriefings (CISD) Peer-Support Training program for CHP officers state-wide. MHN partnered with an outside publisher to design and develop hand-held “Quick Reference” guides on suicide prevention as a real-time tool for CHP personnel in the field. As a result, suicides were reduced to an all-time low. CHP is now ranked third lowest nationally in officer suicides.
- MHN developed and delivered a two-day Peer Support Training Program for Corrections Officers and Parole Agents in critical incident first line response. This program was repeated throughout the state. This initiative trained selected peer staff in understanding the impact of critical incidents in this unique work environment, learning the important role of peer support team members in providing appropriate assistance immediately following a workplace critical event, and developing competency in delivering the “Assess and Refer” model of Peer Support with the core element of administering Psychological First Aid. This initiative resulted in the development and delivery of two follow-up skill-building programs for the Corrections Department: Suicide Prevention training to Peer Support Team members and a “Managing Stress” program tailored for a new Corrections Officer Academy.
Providing Behavioral Health Benefits to Military
Nearly ten years ago, the Department of Defense (DOD) was seeking support services that could complement existing military behavioral health programs to support Service Members and their families who were struggling under the effects of extended and repeated deployments due to the Iraq and Afghanistan conflicts. MHN Government Services, Inc. (MHNGS) was selected to pilot a solution for DOD’s challenge in what has become perhaps the most important support program offered to Service Members and their families today: the Military & Family Life Counseling (MFLC) Program.
In 2004, MHNGS sent the first team of 20 consultants to Germany. The MFLC’s mission was to augment existing support to active military troops and their families through the provision of non-medical counseling services geared toward short term problem resolution. In 2007, MHNGS was awarded the first MFLC contract to implement a fully mature program which grew to include additional services and outreach capabilities.
Since 2004, MHNGS’s licensed clinical providers assist Service Members and their families with issues they may face throughout the cycle of deployment - from leaving their loved ones and possibly living and working in harm's way to reintegrating with their family and community. The MFLC Program provides short-term, non-medical counseling support for a range of issues including: relationships, crisis intervention, stress management, grief, occupational and other individual and family issues. Psycho-educational presentations focused on issues common to the military family including: reunion/reintegration, stress/coping, grief/loss and deployment are provided to commands, Family Readiness Groups (FRGs), Soldier Readiness Processing and other locations, as requested. Support for these issues empowers individuals during the problem-solving process, increases individual and family competency and resilience in coping with the challenges of military life and ensures that these issues do not detract from operational readiness.
Through the use of telemedicine, MHN facilitates the assimilation of American soldiers back into American life, and prepares families for the return of their loved ones.
HEALTHCARE INTEGRATION IN THE ERA OF THE AFFORDABLE CARE ACT
Changes are occurring across the healthcare landscape, with a significant focus on integration of behavioral and physical health. This paper is intended to help inform these efforts by focusing on the long history Association for Behavioral Health and Wellness...[More]
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