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Behavioral Health Services

A Far-Reaching Commitment

To Improved Mental Health Care

The National Alliance on Mental Illness estimates that serious mental illness costs the United States $193.2 billion in lost earnings per year, and mood disorders like major depression are the third most common cause of hospitalization in the U.S. for people ages 18-44. Even more alarming, it is the second most common cause of death for people ages 10-34 and the tenth-leading cause of death for the overall population. Additionally, there are more people receiving treatment for severe and persistent mental illness in state prison systems than hospitals.1

Now, more than ever, behavioral health care is vital to the overall health and wellness of our members.

Whether members are struggling with depression, anxiety, alcohol or drug dependence, CareSource provides treatment and counseling options to help them through the most difficult times in their lives.

In 2019, CareSource made significant internal realignments to create a more responsive operating structure for our members’ behavioral health needs. Our behavioral health division now stands alone from our other products so we can not only devote dedicated resources to our members’ care, but also create specific solutions for specific communities. We’ve also reimagined our value proposition, strengthening our relationships with Community Mental Health Centers and Substance Use Disorder Providers to ultimately get more members into quality behavioral health care.

Certainly, when a member has a behavioral health concern, they face other life challenges as well. Here especially, our holistic approach to health care becomes vital as we help our members not only with their health care, but with societal factors like housing, employment and even foster care and the criminal justice system. We embrace complex issues that often confound other insurers.

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The Whole-Person Approach

For behavioral health, CareSource is all in. Too often, quality care is difficult to access and members with behavioral health needs are overlooked. CareSource prioritizes behavioral health (BH), and we are making a difference.

We get more people into the right care.

Our top goal is to get more people into effective and efficient BH care.

  • Increased engagement in community care
  • Realized margin and administrative costs
  • Lowered hospitalization
  • 13K+ more members with substance use disorder (SUD) needs received 127% more services
  • 10% lower hospitalization

We produce quality and value.

Our responsibility is to ensure quality while managing costs.

  • Best among competitors in BH Healthcare Effectiveness Data and Information Set (HEDIS) quality measures
  • Realized margin and all administrative costs
  • Drove down medical costs
  • $50M+ in Quality P4P for BH measures
  • $8.5M+ in medical cost reduction

We work to strengthen our Community Behavioral Health Centers (CBHCs).

Our priority providers create a vital safety net for our members.

  • Deployed BH Health Partner resolution teams
  • Partnered with operations to timely resolve issues
  • Connected CBHCs to hospitals and emergency departments to improve transitions
  • 450+ CBHCs were joined with accountable Health Partners
  • 99%+ claims paid within 2 weeks

We create sustainable community collaborations.

Our goal is to improve care, partnering locally for unique solutions and capacity development.

  • Added peer support to emergency departments
  • Created SUD residential centers as hospital alternatives
  • Integrated BH telehealth in school clinics
  • 10+ new innovative services in local communities
  • 6+ law enforcement departments trained in Mental Health First Aid

We run to problems that others run from.

Our focus is to assist states with their priorities and address seemingly intractable problems.

  • Partnered with police, courts, prisons and jails to improve treatment coordination and diversion
  • Reduced opioid prescriptions and increased access and engagement in medication-assisted treatment (MAT) and SUD community care
  • Produced Ohio’s first suicide prevention plan with the Ohio Suicide Prevention Foundation
  • 50%+ opioid dosing reduction continued
  • 18,000+ members supported through transition from incarceration