Posted: Tuesday, March 28, 2017

HealthPath, a groundbreaking collaboration between Care New England, Blue Cross & Blue Shield of Rhode Island, and Continuum Behavioral Health, a for-profit division of The Providence Center, uses the Medicaid Health Home model employed by community health centers for behavioral health and applies it to commercially insured patients. HealthPath’s wrap-around approach to care has led to improved outcomes for hundreds of clients.

Continuum’s director, Ian Lang, provides some insight into the first two years of the program.

How did this project get off the ground?

Blue Cross & Blue Shield and Care New England identified high-cost areas where they felt new approaches could have a significant impact, and behavioral health was one of them. It had become clear that the fee-for-service model wasn’t working, so the idea was to build off of the Medicaid Health Home concept of a coordinated team providing comprehensive services and bring it to the BCBS enrollees suffering from substance use disorders. TPC was selected because we have a reputation for looking at new ways of solving problems.

Do you think this model can be applied to people with different levels of need?

Absolutely. In fact, we’ve recently launched HealthPath Connect, a step down program designed for clients who need less care. Our aim is to minimize the gaps between HealthPath and regular outpatient appointments. We feel that we have a responsibility to provide people care that meets their specific situation, and basing our services on need instead of volume allows us be more flexible in doing that.

What have you learned in this process that surprised you?

We know that mental illness isn’t determined by socioeconomic status, but it was still surprising how sick many of our clients were. I think sometimes there’s a perception that this audience will be have less acuity. The reality is that we’re seeing Daily Living Assessment scores that are just as low as clients with Medicaid from TPC Health Home programs.

What is ahead for HealthPath?

We’ve recently expanded our original location in Cranston to include offices in Providence and North Kingstown, and are working on ways to be more accessible, like partnering with other insurers.  We’re also trying to get better data and more analysis to identify the clients that need higher levels of care earlier. Most of our clients come to us directly from an inpatient say, so being able to prevent that would put make their recovery process easier and save the system money.

By the Numbers:

Medical Costs for Clients that successfully completed Health Path vs Test Group: