BIP Fall 2024

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We need to explain that there is the ability for a patient to step up and step down into other

as any other type of care, the reality is, “that’s not true,” said Kennedy. Recovery is a multi-stage process and not as straightforward as the solutions many carriers propose. “We see an awful lot of carriers coming forward with self-help and mindfulness apps, and that’s great for somebody that’s in the ‘healthy’ or ‘reacting’ categories,” Kennedy said. “But when you get into the ‘injured’ and ‘ill’ levels, it’s not going to give the treatment that’s truly needed.” While many brokers understand therapy and acute inpatient, there are myriad levels in the middle. And brokers need to not only understand the care continuum themselves, they also need to educate their clients about it, said Kennedy. “We need to explain that there is the ability for a patient to step up and step down into other levels of care,” she said. “And that full continuum of care bodes best for the most optimal outcome.” Care levels 101 For brokers to be effective in advocating for the care continuum, they first need to explain it to their clients. • Inpatient is the most acute stabilization, with psychiatry available. From there, the individual should be discharged and moved to residential. • Residential is a contained, safe environment for medication, group and individual therapy. “Indicators of a better-run residential facility are trauma-informed and evidence-based care,” Kennedy said. • Partial hospitalization is the next step down at six

school, so morning or evening programs are available. • Therapy can be one or up to three days a week before moving up to intensive outpatient. “Most of us have in our minds that therapy is once a week or once every two weeks, but that can be escalated at this level if the patient needs more support,” Kennedy said. “And then, of course, from therapy, there is early intervention and prevention.” Navigate the process Brokers can be a key resource to navigate the authorization and utilization processes for clients. “We need all NABIP members to learn this information so that we can be better advocates for our clients, our families, the employees and the average American,” Kennedy said. “Treatment works, but we need to do it strategically. We cannot let people be discharged without knowing where to go next. How do we get people from point A to point B when they’re not able to do it themselves? It’s the effectiveness of the advocates. You have a role in that.”

levels of care. And that full continuum of

It takes an average of 11 years from when a mental health

care bodes best. — Dede Kennedy

symptom emerges to when treatment begins,

”

according to the National Institute of Health.

to eight hours a day, and it will include psychiatry. On a once-a-month basis, therapists will run group and individual therapy to continue the kind of treatment the individual had started in inpatient and residential. • Intensive outpatient is typically two to four hours a day. Most people will pair it with working or attending

NABIP TAKES ACTION NABIP’s Mental Health Working Group is actively working to craft legislation around mental health benefits access based on what it has learned from stakeholders and evaluating legislation nationwide. The association is developing a course on mental healthcare fraud, waste and abuse. The curriculum will cover how to identify legitimate, evidence-based treatment teams and treatment facilities with good outcomes. “NABIP is being proactive, and it’s wonderful,” said Kennedy. “I want to thank the members of the Mental Health Working Group for your effort and for the ways in which we are going to make [mental healthcare access] materially better for American consumers.”

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