Blue Cross Blue Shield of Vermont is teaming up with the Brattleboro Retreat to create a company aimed at integrating mental health and substance abuse services with those of traditional health care.
On Tuesday, leaders from Vermont’s largest health insurance company and private psychiatric hospital announced the creation of Vermont Collaborative Care. The 16-person limited liability company will open its doors to Blue Cross’ 200,000 members on July 1. While the LLC will only work with Blue Cross at the outset, its leaders are interested in contracting out to other health care organizations in the future.
Vermont Collaborative Care is meant to bring management of health care benefits for physical and mental illnesses closer together.
“Pretending the mind and body are not integrated has not served health care well and has not served patient care well,” said Rob Simpson, president and CEO of the Brattleboro Retreat.
Right now, for example, health care providers and patients call two separate Blue Cross numbers for health insurance authorizations, depending on whether the issue is mental or physical. Blue Cross CEO Don George said at the press conference that Vermont Collaborative Care would change that.
“No longer will people call a separate phone number for their mental health substance abuse services and a separate phone number for their medical services,” he said. “It’s integrated; one approach.”
George said that the Blue Cross phone number for mental health services actually connects to Magellan Health Services. Blue Cross Chief Medical Officer Robert Wheeler and his team manage cases on the physical end of the health care spectrum, and Blue Cross contracts out to Magellan to provide mental health-related services.
Vermont Collaborative Care will replace Magellan. It will manage cases on the insurance end, but it will not take on the financial risk that a health insurance company does. Wheeler said that this measure ensures decisions would be made without prioritizing revenue over care.
“We are launching a combined approach,” Wheeler said. “Our analytics will take all of the claims from mental health, substance abuse, physical health, pharmacy and combine them in a way that allows us to look at the whole person and identify patterns that are useful in helping to guide care.”
Simpson explained that mental health illnesses, like depression, often accompany severe physical injuries. This new company, Simpson said, will enable Blue Cross to work with providers to better account for psychiatric ailments that may follow physical ones.
“When you don’t treat the depression and you have these other illnesses, you’re essentially not treating the illness,” Simpson said. “We want to make sure we’re treating them together.”
Blue Cross’ George said that his firm partnered with the Brattleboro Retreat because the hospital has expertise in this area. George said the Retreat’s managed service organization, called PrimariLink, has laid the groundwork for this joint venture.
Peter Albert, vice president of Government Relations and Primarilink at the Brattleboro Retreat, will be the president of Vermont Collaborative Care. He said the company would work with patients to help them get the most out of their health care benefits.
“We’re going to look at the benefits you have and find services for you,” Albert said. “We won’t be limited by saying no; it takes no creativity to say no to someone who needs help.”
Albert said the company would help people solve their health care problems, “So that people’s life experience is better. And, in turn, you (the company) start saving a little money to reinvest in all of those creative things clinicians have wanted to do for years, but have not been able to.”
Creating the separate entity also allows for growth, Wheeler said.
“Vermont Collaborative Care, for example, could sell services to MVP, to the Onecare Medicare ACO and perhaps to other entities,” he said.