CHCC Special Project on Improving Mental Health Benefits
On June 6, Laura Reding, COO of SEIU Local 775 Benefits Trust presented the data-informed journey of the trust's efforts to improve access to appropriate, evidence-based mental health services to a population at high risk of endorsing depression and anxiety symptoms. The presentation describes a comprehensive approach beginning with understanding occupational risk factors and prevention strategies to testing, revising and expanding marketing tactics.
Laura Reding is the Chief Operating Officer of SEIU Local 775 Benefits Trust Group. She leads the policy, operations, and strategy of a Taft-Hartley Trust delivering health and wellness benefits to more than 55,000 home care workers in Washington state. In a historic first, the Health Benefits Trust expanded medical and dental coverage to the children of 23,000 home care workers under her leadership.
Laura has 20 years of healthcare experience including care delivery, benefit purchasing and administration, utilization management, and healthcare operations. She holds a Bachelor's degree in Psychology from the University of Notre Dame, a Master of Science in Counseling from University of North Carolina at Greensboro and earned her Master in Business Administration from the University of Washington.
High-level Findings from 5 CHCC Member Interviews
Thank you to the 5 CHCC members who participated in one hour interviews about their mental health benefits. The members interviewed include sponsors covering both education employees and those working in construction trades. Below are some takeaways from the interviews:
Trusts typically sponsor a self-insured plan in which behavioral health may be carved out with a separate vendor from the medical plan, with a PBM that may be administered separately; a fully-insured HMO with behavioral health managed by the HMO; and a stand-alone Employee Assistance Program (EAP). They may also sponsor wellness programs with incentives for participation and answering questions in a health risk assessment.
They are adding telehealth options in self-insured offerings, including tele-behavioral health. Tele-behavioral health appointment wait times are shorter, with fewer “no shows.” Some sponsors are adding holistic programs and mobile apps to address stress and trauma through prevention and self-care strategies. They are adding or considering point solutions such as tele-physical therapy that promote non-opioid pain management.
Behavioral health is included in the HMO offering, but sponsors are not confident members are able to access needed services. Urgent cases may be assessed quickly, but follow up treatment wait times can be long (beyond 14 days) for both urgent and stable cases. Some sponsors offer EAP and other supplemental services to HMO plan enrollees.
Navigating multiple benefit options for behavioral health conditions is challenging. Despite sponsor outreach efforts, uptake of some options is low. Stigma, lack of awareness, lack of convenient access options and language and cultural barriers may all play a role. Multiple provider directories and narrow or “ghost” networks add to the complexity.
Sponsors are not satisfied with the data and metrics available to them to evaluate the effectiveness and other outcomes of various offerings. Data may be siloed in different vendors making it difficult to get a full picture of care episodes, utilization, and prevalence of diagnoses. There are only a few standard HEDIS measures and screening tools.