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America’s Healthcare Insurers Should Fully Cover Behavioral Healthcare During the COVID-19 Pandemic

Like so many other preventive care actions, it is less costly to pay for behavioral health coaching now than an exorbitant hospital bill later

Thrive Global | THRIVING IN THE NEW NORMAL | April 8, 2020
By Terren Peizer; Ontrak, Inc. Chairman of the Board and Chief Executive Officer

As COVID-19 cases and fatalities mount, even the most rock-steady among us feel our anxiety rising.

Now imagine being one of the 40 million U.S. adults with an untreated anxiety disorder.

Even under “normal” times (read: when every news source isn’t filled with stories about a deadly global pandemic) people with an anxiety disorder are six times more likely to be hospitalized for psychiatric disorders than those who do not suffer from anxiety disorders. With real, tangible anxiety drivers such as cable news “death tickers” now confronting them constantly, the likelihood that they will end up in a hospital grows exponentially.

Worse, their unrelenting fears could actually lead them to become exposed to the virus once there, when they might have otherwise remained safe at home.

What these vulnerable people need is help and reassurance—which is in as short of supply in the health system right now as an N95 mask.

Compounding the issue is that many people with existing but untreated anxiety disorders have avoided seeking behavioral healthcare because of shame, stigma or feeling like the conventional healthcare system won’t be able to help them. Which means even if providers outside of the hospital, like primary care physicians, had the means to treat these patients, they wouldn’t be able to because they don’t know who they are.

Chronic disease and anxiety: a dangerous pair

As we now know, people with chronic or underlying conditions are at higher risk of the most severe outcomes of COVID-19. Recent research by the CDC found that the vast majority of COVID-19 patients in the ICU had one or more underlying conditions, and almost all patients who have died from the disease had an underlying condition.

Untreated anxiety disorders exacerbate chronic diseases such as diabetes, hypertension and other medical conditions. Again, many people are reluctant to seek care. This is why their behavioral health issues—and chronic medical conditions—are largely unmanaged. From any angle, it’s clear that anxiety heightened by COVID-19 fears must be taken seriously.

So how do we address this? The answer lies with healthcare insurers, who in recent years have increasingly taken proactive measures to connect their members to behavioral health coaching that improves their physical health and mental wellbeing. Making behavioral healthcare a fully covered benefit, at least during the worst of the COVID-19 pandemic, would help even more members during this extraordinary time while perhaps removing some of the stigma.

The next step is to identify which health plan members have untreated behavioral health issues along with their chronic medical conditions, such as diabetes and hypertension. There are many more of these members than America’s health insurers might realize. At some point in their lives, over 31% of Americans will experience an anxiety disorder.

Engaging those who need behavioral healthcare the most

Once identified, these members must be proactively engaged to enroll in an appropriate behavioral health program. This is actually easier right now due to COVID-19 as more members are at home and responsive to phone calls.

But it still requires sustained effort and repeated outreach. Building trust and rapport is key to helping people manage their anxiety for the long-term. That calls for experienced behavioral health coaching, which leads to another important point: newly loosened restrictions on telehealth.

Health insurers should beware of directing members to unproven, largely untested telehealth options now advertised on social media. It’s becoming a Wild West out there for medical and behavioral telehealth. At some point in the future, either the government or private lawyers may decide the lighter restrictions were not such a good idea, and may seek compensation from those who made the initial recommendations – and have the deepest pockets.

That said, it is essential to connect more people to effective programs soon. Left unaddressed, many Americans’ escalating anxiety levels could impact hospitals at the worst possible time. Healthcare insurance companies must take action to prevent this and fully cover behavioral healthcare.

It won’t be a money loss to do so. On average, high risk members can generate more than $33,000 annually in medical claims due to physical health crises that could have been averted if they were engaged in the right behavior change programs. Like so many other preventive care actions, it is less costly to pay for behavioral change coaching now, than an exorbitant hospital bill later.