At the Behavioral Health Business VALUE conference held this past March in Miami, Florida, a special interest in data-driven behavioral healthcare prompted a panel of industry leaders to highlight the importance of collecting robust patient data to address behavioral health equity in historically underserved populations and overall access to mental healthcare in conversation with payer negotiations.

Industry panelist ReKlame Health CEO Evans Rochaste–a mental health service provider based in New York City that offers psychiatric and addiction care specifically for Black Indigenous and Person of Color (BIPOC) communities–noted his organization collects extensive data beyond typical behavioral health metrics in an effort to close the gap to accessible care. Taking their cue from the World Health Organization (WHO), this practice includes the tracking of social determinants of health such as transportation access, food insecurity, and housing status. These and additional comprehensive data points are essential for transitioning to value-based care models aligning care and business operations to patient outcomes which then present additional payer negotiation options.

Rochaste went on to emphasize the importance of engaging populations who traditionally have lower healthcare utilization rates. ReKlame’s patient demographic is approximately 55% BIPOC, as is about 90% of its care team, reflecting their commitment to cultural competency in the services they provide as a healthcare presence deploying Diversity, Equity, and Inclusion (DEI) tactics to best serve the community.

ReKlame cites recently published statistics on the practical use of behavioral health services for racial and ethnic minorities in America as a driver of their mission. The study revealed these groups are 20% to 50% less likely to initiate mental health services and 40% to 80% more likely to discontinue treatment prematurely compared to other populations. In response to these mental health disparities, numerous behavioral health providers are implementing data-driven approaches with an emphasis on equity. These approaches present simplified payer negotiations to BIPOC groups with a defined need for behavioral health care, who then benefit from accessible services in face of fees and social stigma present in the community.

These service utilization gaps have also prompted initiatives to further tune or otherwise extend services towards marginalized communities, including Medicare and Medicaid beneficiaries, communities of color, and unhoused populations in need of behavioral healthcare presenting additional pathways for payer negotiations.

Key Points

The studies on ASD and substance use highlight several significant findings:

• Disparities in Mental Health Service Utilization: Racial and ethnic minority groups are significantly less likely to initiate and continue mental health services compared to their counterparts.
• Data-Driven Approaches: Behavioral health providers have begun to leverage detailed patient data to improve care for underserved populations aiding payer negotiations.
• Data-Driven Whole Person Care Model: More than a trend, behavioral healthcare run by professionals representing the community they serve with cultural competency is becoming an increasingly common practice. 
• Value-Based Care Transition: Intensive data collection supports the shift to value-based care models, demonstrating cost savings and improving reimbursement negotiations.
• Comprehensive Data Collection: Providers tracking social determinants of health emphasize the importance of understanding the broader context of patients’ lives to improve health-based outcomes, and justify payer negotiations favoring services when they are more likely to be impactful on lifelong wellbeing.

Conclusion

According to Focus Psychiatry Magazine, equity in the future behavioral healthcare system is likely to include more robust data collection, culturally competent care, and tailored services to better meet marginalized populations on the care continuum. Providers like ReKlame Health are leading the charge. In advocating for predictive care models by prioritizing inclusivity in their whole-person care model–they consider program affordability and empathize with BIPOC groups in need of behavioral health services–providers work towards more flexible payer negotiations.

Industry leaders continue to keep track of the ability to record lifestyle-coded metrics in typical practices while typical recording strains existing systems. At the same time, they acknowledge patient-centric care has the potential to leave lasting positive patient outcomes especially when considering lifestyle and environmental health factors.

Following implementation, providers are anticipated to be in a better payer negotiation position and ensure an ongoing, more sustainable, value-based care system by incorporating these additional data points. Behavioral health experts hope to shrink BIPOC premature drop-off statistics by centering the patient and their experiences to their behavioral health plan. Providers hope to retain more patients once able to embed themselves in underserved, predominantly BIPOC communities in need of behavioral health services with Medicare and Medicaid contributions.

Sources: https://bhbusiness.com/2024/05/31/data-driven-approaches-improve-behavioral-health-equity-aid-payer-negotiations/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011222/