Helping Employees Reach Their Potential at Work and in Life
Mental health issues affect every business. Studies show one in five Americans has a mental health disorder, and most of them have not received treatment.1 Employees who get proper mental health care may feel more satisfied with their jobs, perform better at work and incur fewer medical costs.2
The Behavioral Health program from Blue Cross and Blue Shield of Texas (BCBSTX) engages members across the care continuum – from short-term life events to serious mental illness and substance use disorders. Our licensed behavioral health clinicians can help them overcome barriers to achieving treatment goals and discover healthier versions of themselves.
A Guiding Hand Through Challenging Situations
Our case management program:
- Targets common behavioral health conditions for outreach and engagement, whether members need help adjusting to a life event or require more intensive intervention.
- Employs compassionate, attentive case managers who help employees understand their condition.
- Helps members locate resources that can help support their treatment plan with the goal of improving their medical, financial, emotional, physical and social wellbeing.
Making a Difference for Employees with Distinct Needs
Some behavioral health conditions require a specialized approach, due to their complexity and sensitive nature. BCBSTX has established programs to effectively address the challenges inherent in managing these disorders.
- The autism response team assists families in planning an appropriate course of treatment for their child with an autism spectrum disorder diagnosis.
- The eating disorder care team provides education, care planning and support to members with anorexia, bulimia and binge-eating disorders.
- Risk Identification and Outreach (RIO) identifies members who may benefit from specific, clinical interventions. The program currently focuses on uncovering potential opioid and substance misuse for outreach and coordination of care.
Promoting Effective Treatment
Behavioral health treatment plans can be complex, expensive and subject to fraud, waste and abuse. Our utilization management processes help ensure both inpatient and outpatient behavioral health services are clinically appropriate and likely to contribute to successful outcomes.3
By delivering proactive management programs through the complete continuum of care, our clinical operations staff can positively impact a wider range of behavioral health outcomes and costs.
Easy Access to Care and Support
Employees have access to a nationwide network of more than 430,000 behavioral health professionals and treatment facilities through Provider Finder®.4
Members and providers can also call the Behavioral Health number listed on their BCBSTX member ID card for prior authorization and other questions. Behavioral health clinicians are available 24/7 for urgent issues.
Clear Outcomes and Savings
Employees with untreated mental health conditions use three times more non-psychiatric care than those who receive treatment. Straightforward reporting clarifies behavioral health program results to help inform key business decisions.
Information-driven Approach to Opioid and Substance Use
- The current focus of our Risk Identification and Outreach (RIO) program is to modernize management of substance use disorders to drive employer and member cost savings and overall health improvements.
- Data from medical and behavioral providers, hospitals, pharmacy transactions and lab results identifies members at high risk for addiction.
- Clinicians from our multi-disciplinary team support these members in finding safer pain management and coping strategies.
To learn how the Behavioral Health Program can support your groups and their employees, contact your BCBSTX representative.
The Behavioral Health program is available only to those members whose health plans include behavioral health benefits through BCBSTX. Some plans may not include outpatient behavioral health care management. Information members may receive from the program does not replace the care of a physician. Members are encouraged to share any concerns they may have with their behavioral health professional or physician.
1 State of Mental Health America 2018, Mental Health America. http://www.mentalhealthamerica.net/issues/state-mental-health-america.
2 Bad for Business: The Business Case for Overcoming Mental Illness Stigma in the Workplace. National Alliance on Mental Illness Massachusetts.
3 Prior authorization is required for some behavioral health services, including inpatient care, residential treatment, partial hospital admissions, intensive outpatient programs (IOPs), applied behavior analysis (ABA) treatment, outpatient electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS).
4 Applies to PPO plans with BlueCard® access.