The company is the first among second opinion/concierge vendors to use relevant experience and quality metrics to refer clients to behavioral health providers beyond psychiatrists, including 280,000 non-physician providers
PEMBROKE, Mass. (January 16, 2018) – ConsumerMedical, a leading health care decision support and concierge company, can now refer employees to high-quality behavioral health providers across the mental health and substance abuse spectrum for needed care as well as for an expert second opinion. The company is the first among second opinion/concierge vendors to use relevant experience and quality metrics to refer participants to behavioral health providers beyond just psychiatrists; the company has such data on 280,000 non-physician behavioral health specialists including psychologists, social workers and substance abuse counselors. The expansion complements ConsumerMedical’s existing capability to refer employees to high-quality psychiatrists for needed care and second opinions.
“This is a very exciting opportunity,” says David Hines, CEO of ConsumerMedical. “We are in a great position to help improve navigation support to timely and high-quality behavioral health care due to the fact that a large number of individuals we support for medical conditions are experiencing behavioral health issues such as clinical depression, bi polar and anxiety disorders, and opioid addiction. This service will help them get in faster and also see the best,most appropriate and most affordable provider for their needs.”
In many instances, it is more appropriate and also more cost effective for an employee to see a licensed social worker or therapist for a behavioral health issue, instead of a psychiatrist—and these providers are generally more widely available, highly effective and almost always less expensive. Critical to finding the right behavioral health provider is ConsumerMedical’s ability to zero in on the frequency with which providers treat different types of behavioral health issues. “For example, to get the right care, the patient dealing with a substance abuse concern should see a provider who cares for a significant number of patients with substance abuse issues, such as a certified addiction counselor,” explains Hines.
An estimated 18 percent of U.S. adults have some type of behavioral health issue. Thirty percent of individuals with medical conditions also have a mental health issue, and 70% of individuals with a mental health condition have other medical issues. Addiction plays a role as well—for example, between 2007 and 2014, opioids led to a 3,000 percent rise in the need for medical services.
“When it comes to behavioral health, medical and pharmacy claims are only part of the picture,” says Hines. “Mental illness and substance abuse costs employers an estimated $225.8 billion each year, but then you look at absenteeism and productivity, and there are other major costs, too.”
ConsumerMedical’s new offering is available to employees and dependents of the organization’s employer customers, as well as its health plan clients’ members.
“What is especially helpful is that an employee can use this service for themselves or a loved one, for example a child with ADHD or a teen with a substance abuse problem,” explains Hines. “These issues take a toll on the whole family.” In fact, a recent survey conducted by ConsumerMedical found that almost half of employees surveyed had dealt with a mental health issue on behalf of themselves or a loved one in the last year.
About ConsumerMedical – ConsumerMedical is a leading health care decision support and concierge company serving over 2 million individuals through some of the nation’s largest employers, health plans and private exchanges. The company has been serving patients and payers for over 20 years. As a Medical Ally, ConsumerMedical guides participants throughout their health care journey with compassionate, high-touch support and deep clinical expertise. ConsumerMedical offers a fully integrated suite of solutions including Medical Decision Support, Surgery Decision Support, Expert Medical Opinion, Claims Advocacy and more, helping individuals and families navigate the health care system while improving outcomes and reducing costs. ConsumerMedical’s results have been validated continuously by independent actuaries. More information is available at www.consumermedical.com.