With behavioral health conditions impacting one in five Americans, it’s no wonder we’re seeing more employers search for ways to provide members with better access to behavioral healthcare benefits.
Statistics show that many employees, including some that are insured, fail to get the mental healthcare they need. Because self-funded health plans provide plan design flexibility, some plans are taking bold steps to address this growing need. While many are using telemedicine to improve access and lower costs, some employers are treating out-of-network behavioral health treatment as in-network, enabling employees to pay the same amount for treatment regardless of which provider they use. Others are covering out-of-network behavioral healthcare services even when their plan doesn’t cover out-of-network services for other types of care.
When you consider that mental illness has become the greatest cause of disability claims in the U.S., it is not surprising that employers are looking for ways to help employees obtain the care they need.
Significant Action is Warranted
There is plenty of research to show that Americans are not getting the mental healthcare they need. According to Mental Health America, despite having health insurance, 56.5% of adults with mental illness received no treatment in the past year.
Another problem is that behavioral health treatments are rarely classified as primary care, and are regarded instead as specialty treatment. This makes people find an in-network provider, go out-of-network, pay higher out-of-pocket costs or avoid treatment altogether. Claims data from Collective Health shows that more than 40% of the 2017 behavioral health spend was out-of-network, which is many times the amount spent on primary or preventative care.
Have you tried to monitor your health by counting carbs, calories or protein? While health can feel like a game of numbers, it can help to know measurements that matter most. Here are a few numbers that may help:
50%. That’s the proportion of your plate that should contain vegetables. The rest of your plate should include 25% whole grain, such as brown rice and 25% of protein rich food, such as fish, beans or chicken. Using a plate model can be much easier than counting calories.
25-35 grams. Aim to take in 25 to 35 grams of fiber a day. Most Americans only take in 16 and low fiber can cause issues with high cholesterol and blood sugar levels, increased risk of certain cancers and digestion problems.
7-8 hours. Sleep is necessary for a healthy lifestyle, so try to get 7 to 8 hours. A lack of sleep can increase risk of Type 2 diabetes and obesity, and lead to complications such as loss of focus, impaired memory retention and irritability.
150 minutes. Aim for 150 minutes of activity per week, spread throughout each day, with a minimum of 10 minutes per session. Activities you enjoy are the ones you’re more likely to do regularly.
120/80. Blood pressure is called the “silent killer,” as it can often be present without any symptoms. Unchecked or untreated, high blood pressure can increase the risk of heart attack or stroke. Monitoring is key, as well as frequent exercise and a healthy diet.
The time to think about diabetes is not when it’s diagnosed. It’s important to take steps to prevent diabetes and prediabetes before they ever develop. While more than 100 million American adults live with diabetes or prediabetes, there are easy, proven ways to prevent it. Here are just a few:
Eating better: the breakdown. Though we often hear that we should “eat better” it’s not always clear what that means. Whole, fiber-rich foods are what you should be consuming. Fill your plate with vibrant foods, having natural color and fiber, such as quinoa, brown-rice, blueberries and garbanzo beans. These foods are slow-burning, providing longer term energy and maintaining sugar levels more steadily. When eating a meal containing slow and fast burning foods, eating slower-burning foods first will slow the absorption rate of faster-burning foods.
Water is your best friend. While the call of sugary drinks such as juice, packaged iced tea and soft drinks can be hard to resist, water is always the best choice. Even diet or low calorie drinks can increase the risk of diabetes, potentially causing changes in gut bacteria that affect metabolism. Water eliminates stripped carbs and provides the hydration your body needs.
Keep moving. Exercising regularly, doing both cardio and resistance activities, not only lowers your blood sugar but makes your cells more sensitive to insulin. That’s really a two-for-one diabetes prevention action! Choosing activities that you and your family enjoy makes exercise fun.
States are moving toward telemedicine to help students access mental health services. Minnesota and Utah have proposed telemental services in order to reach students with underserved mental health needs. Students with unmet mental health needs experience many obstacles, with conditions such as depression and anxiety negatively impacting their attendance and performance.
Telemental health is being utilized to reach those in areas without child therapists or in other “healthcare deserts”. Texas has successfully implemented telemental health programs since 2012, connecting thousands of students with much needed care and treatment. One proposed Minnesota bill suggests launching four telemedicine projects aimed at improving access to telemental health services for students. Proposed grants would help provide dedicated space in schools and the technology needed for students to access telemental health services. A bill in Utah would enable the Division of Substance Abuse and Mental Health to create a two-year program using a telemedicine platform to facilitate remote consults between children and child psychiatrists.
Legislators and school officials in a number of states see many benefits to pursuing a telemental health platform, including the potential to identify young people contemplating suicidal or homicidal actions.
For the first time in years, Americans took more time off from work in 2017. A survey of 4,400 workers conducted by the travel industry showed that on average, 17.2 days of vacation were used last year. This was more than a full day greater than in 2014. While more vacation time was enjoyed, work pressures still kept more than half of those surveyed from using all their earned vacation days in 2017.
A study of nearly 700 individuals with coronary artery disease has revealed that hearts in men and women react differently to a temporary reduction in blood flow to heart muscles, a common symptom caused by stress. While some men may experience an increase in blood pressure and heart rate, making their heart work harder, about 1 in 5 women experienced constriction in their smaller blood vessels, which can cause more serious heart complications. American Heart Association representatives recommend physical exercise as a way to manage mental stress. Exercise will make blood vessels dilate, counteracting the constriction seen by some of the women who participated in the study. Regular exercise, like a daily walk or run, can go a long way in helping us cope with mental stress.
Even though on-site clinics are not revolutionary, the announcement by Apple seems to have captured more attention because of the excitement generated by newsmakers Berkshire Hathaway, JP Morgan Chase and Amazon. Apple, currently working to add medical personnel, expects the clinics to be available at their Cupertino, California headquarters this Spring.
Financial wellness, standing desks and other wellness strategies are high on the list of benefits trending upward in 2018. According to the Society for Human Resource Management, a growing number of organizations are offering programs to help employees improve their financial well-being. Some companies are providing debt counseling and help with repayment of student loans. Standing desks are becoming very popular, with a growing number of companies offering them to employees as a new wellness benefit.
Health policy researchers at Mayo Clinic recently found that only 12% of patients who sought a second opinion for a complex medical condition at Mayo Clinic received confirmation that their initial diagnosis was correct and complete. This should be reason enough to begin educating employees about the benefits of second opinions and how to get them. Common concerns expressed by patients include a fear of offending their physician, a feeling of urgency to begin treatment and of course, concern that their health plan may not cover the cost of a second opinion.
Whether you use employee newsletters, printed handouts and posters or a lunch and learn, it is important to let employees know that most doctors welcome a second opinion and they should never be afraid to ask their physician how much time they can take to obtain a second opinion before making a decision on treatment. Make sure members know if they have a second opinion benefit and consider offering an incentive for taking an active role in health management.
According to a Medscape survey of more than 19,000 physicians, the average patient spends between 13 and 16 minutes with their physician during an office visit. Given the short amount of time, it is probably best to focus on two or three things you want your doctor to address. It may also help to prepare a list of questions ahead of time. Here are a few you may want to consider.
- Which health websites do you trust?
- What is this medication I’m taking and why am I taking it?
- If you’re a smoker, how can I get help to stop?
- Are my screenings and vaccinations up to date?
- What is a healthy weight for me and how can I get to that?
- What do you do to stay in shape?
- If you’re taking a prescribed opioid painkiller, ask if it’s really necessary and what else you might take?
- What are some things I can do before my next appointment to make me healthier?
- If a test is ordered, ask what it is for and what are you trying to learn from it.
- When a specific treatment is recommended, don’t hesitate to ask about other alternatives.