One of the reasons of why Innovia exists is that a large percentage of people who need help/support don’t actually need clinical treatment or therapy. Implementing a subclinical support system like we provide allows more people to get help, unburdens the caseload for therapists to help those who do clinically need it, and saves a tremendous amount of money.
The ongoing battle between payers and providers, especially in the behavioral health space, likely isn’t going to find an immediate resolution. The chart above from the LexisNexis Risk Solutions report from earlier this year on claims data is helpful, for multiple reasons.
There is another battle going on – between large digital health companies and therapists. Mismatching clients with providers and under-paying those providers for individual therapy sessions has fueled the fire. Of course there is a rise in diagnoses and claims, because people who may be able to be helped in other ways are automatically sent to a therapist and then a diagnosis is required to submit a claim for payment. It’s not only the large digital health companies, they’re just an easy target sometimes.
However, there are things that can benefit “both sides” that focus on better results for more people at lower cost. We would argue that most of these people don’t need to go directly into therapy for treatment. There is another level in between that can help unburden the system, help more of the people who don’t actually need a diagnosis in order to feel relief from anxiety and stress, for example. This is the realm of subclinical support. This allows for those who do need clinical interventions to be matched up better with those therapists who can best help them, as they’re not now bogged down with a huge caseload and burnout from mismatched clients and low pay.
People should be able to get more help, more often. Therapists should also be able to be paid more. When claims go up, premiums and co-pays also go up, while reimbursement rates for providers go down even further. Simple economics. It’s the system that needs to be fixed, and baking in another layer can help unburden a lot of this. We aim to help this, on a very large scale.
Let’s do some simple math this morning as an example of how much we can save payers in just this one area.
We’ll say Plan A has 500,000 members, and 50,000 of them receive some sort of behavioral health treatment in a calendar year (we’ll choose a single therapy session, reimbursed at $60). By implementing and utilizing our services throughout the year, if we can help reduce the number of therapy visits by even just one per person per year, we can save them a minimum of $3,000,000. This would be a bare minimum goal, and doesn’t include other behavioral health treatments we can help prevent.
We already know we’re doing this simply through anecdotal data from our members, and excited to show this on a much larger level in the coming years.
Higher utilization of our services can not only reduce the number of therapy visits by even more (thus continuing to lessen the therapy caseload as well), but healthier, happier people also have less urgent care visits, less emergency department visits, and less illness overall, while also having improved relationships and productivity at work. Therefore, the actual cost benefit is exponentially higher than the $3M in the above minimum scenario.
Care to find out how we can help serve your population? Let’s talk!
